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Bilateral Salpingo-Oophorectomy

Total hysterectomy for endometriosis or adenomyosis

Endometriosis is a disease that affects the reproductive organs and monthly menstrual cycle in women. It can cause cramps and pain during periods or pelvic pain throughout the month. Women who have this disease and let it go untreated may be compromising their health. But, with early diagnosis and treatment, endometriosis can be managed.

Understanding endometriosis

During endometriosis, endometrial tissue grows outside the uterus in the pelvic cavity. During a woman’s menstrual cycle, this extra tissue swells with blood along with the normal tissue in her uterus. The tissue may also release tiny drops of blood. The swelling and blood irritate nearby tissues, causing pain and cramps. Constant irritation may cause scar tissue to form. This scar tissue can bind organs together and cause trouble getting pregnant (infertility).

Common symptoms

If you have endometriosis, you may have one or more of these symptoms:

  • Cramps and menstrual pain
  • Pelvic pain
  • Pain during sexual intercourse
  • Trouble getting pregnant (infertility)

Stages of endometriosis

The stages of endometriosis are ranked as follows: Minimal (I), Mild (II), Moderate (III), or Severe (IV). Staging depends on certain factors. These include the number, size, and site of the implants. The stage also depends on the extent of the adhesions and whether other pelvic organs are involved. The severity of the disease may not match the pain that is experienced. Even mild endometriosis can cause a lot of pain.

Treatment options for endometriosis

Endometriosis can be treated with hormone therapy, surgery, or a combination of both. Talk to your health care provider to see which treatment is best for your condition

Hormone therapy

Hormone therapy regulates or blocks the hormones that control a woman’s menstrual cycle. This means it can limit the swelling of the endometrium and extra endometrial tissue (implants). This treatment may be used before, instead of, or after surgery. The following are different types of hormone therapies:

  • GnRH Agonists and FSH and LH Inhibitors stop or lower the production of estrogen and progesterone hormones.
  • Birth control pillscontain estrogen and progesterone. Birth control pills help to regulate the levels of estrogen and progesterone in your body.
  • Progestins are a form of progesterone. Progestins help keep estrogen levels low.
  • Danazol is a hormone that stops or lowers the production of estrogen and progesterone.


Surgery can be used to remove implants of endometrial tissue or for removal of the reproductive organs. With laparoscopy a thin, lighted tube is inserted through a small incision in your abdomen. The doctor uses the laparoscope and another small instrument to remove the implants. Laparotomy is open surgery to remove large implants that can’t be reached with the laparoscope or when pelvic organs such as your bowel are involved.

Hysterectomy is the surgical removal of your uterus. Any implants or adhesions in your pelvic cavity will also be removed. During a total hysterectomy with bilateral salpingo-oophorectomy (or BSO) procedure, the uterus, ovaries, and fallopian tubes are removed. Any implants or adhesions in nearby tissue are also removed.

da Vinci® Hysterectomy

A new, minimally invasive approach to hysterectomy or total hysterectomy, da Vinci® hysterectomy, combines the advantages of conventional open and minimally invasive hysterectomies – but with potentially fewer drawbacks.

For patients, the benefits of da Vinci® hysterectomy may include:

  • Significantly less pain
  • Less blood loss
  • Less scarring
  • Shorter recovery time
  • A faster return to normal daily activities and
  • In many cases, better clinical outcomes

It is performed using the da Vinci® Surgical System, which enables surgeons to perform surgical procedures with unmatched precision, dexterity and control. Capital Health is the only hospital in Mercer County to offer the da Vinci® Surgical System as a treatment option. Read about what may be the most effective, least invasive approach to hysterectomy – da Vinci hysterectomy.