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Why the tubes come out with the ovaries | CION Cancer Clinics
The fallopian tubes are removed with the ovaries mainly because many of the most common serious ovarian cancers are now thought to start at the end of the tube, not in the ovary. Once the ovaries are gone, the tubes have no remaining job. Taking them out adds very little to the operation and removes tissue where cancer could begin. This page explains the reasoning and what it means for you. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MM
Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Why are the fallopian tubes removed with the ovaries?
- How did removing the tubes become standard?
- Who does this reasoning apply to?
- What words might you see on the pathology report?
- How does removing only the tubes compare with removing tubes and ovaries?
- What do people often believe about removing the tubes?
- What can this page not tell you, and what should you ask?
- Common questions about removing the fallopian tubes
The short answer
Why are the fallopian tubes removed with the ovaries?
The tubes are removed because many ovarian cancers are now thought to begin in the tube, not in the ovary itself. Once the ovaries are out, the tubes have no job left, so leaving them keeps a risk with no benefit.
What the tubes normally do
Each fallopian tube is a thin channel that carries an egg from the ovary to the womb. Its far end is shaped like fingers, called the fimbriae, which sweep over the ovary to catch the egg. Without an ovary releasing eggs, the tube has nothing to carry. It makes no hormones.
Why doctors changed their thinking
For years, ovarian cancer was assumed to start on the surface of the ovary. When pathologists began examining tubes very carefully after preventive surgery in women with BRCA faults, they found very early abnormal cells in the fingered end of the tube more often than expected. That changed how the operation is done.
Who this matters to most
It matters most to women having both ovaries removed, including those lowering an inherited risk. It is also why many surgeons now remove the tubes during a hysterectomy even when the ovaries are kept.
Removing the tubes lowers risk. It does not remove every risk, and follow-up still matters.How practice changed
How did removing the tubes become standard?
-
The older approach
Surgeons removed the ovaries and sometimes left the tubes, because the tubes were not thought to be where cancer started.
-
A closer look at preventive surgery
Pathologists began slicing the whole tube thinly and examining every part. In BRCA carriers, they found tiny early changes at the tube end more often than anyone had expected.
-
A new explanation
The most common serious type, high-grade serous cancer, came to be seen as often starting in the tube and spreading to the ovary and the lining of the abdomen.
-
Tubes removed routinely
Removing both tubes with both ovaries became the standard operation for risk reduction, and for most operations where the ovaries are taken out.
-
Research still going on
Trials are testing whether removing the tubes first and the ovaries some years later can delay menopause safely in gene carriers. It is not yet standard care, and the results are still awaited.
Not sure whether this applies to you?
Ask an oncologistDifferent operations
Who does this reasoning apply to?
The same idea shapes several different operations. Ask which one is planned for you.
Women with a BRCA or Lynch result
Both tubes and ovaries are removed together before any cancer is found, once you and the team agree on timing. The tubes are examined very closely afterwards.
A hysterectomy for another reason
Many surgeons now offer to remove the tubes while keeping the ovaries. The ovaries keep making hormones, so there is no early menopause.
An ovary removed for a cyst
The tube on the same side is usually taken too, because it has little use without its ovary. The other tube and ovary are kept if healthy.
A suspected or known cancer
The tubes, ovaries and often the womb are removed and examined, because cancer may already involve the tubes.
The report may mention
- Whether the tubes are involved
- The omentum, a fatty apron in the abdomen
- Peritoneal washings, fluid checked for cells
On your report
What words might you see on the pathology report?
- Fimbriae
- The finger-like end of the tube, next to the ovary. Early changes are most often found here.
- High-grade serous carcinoma
- The most common serious type of ovarian cancer. Many are now thought to start in the tube.
- STIC
- Serous tubal intraepithelial carcinoma. Very early abnormal cells in the tube lining that have not grown into deeper tissue.
- SEE-FIM
- A way of cutting and examining the whole tube carefully, used after preventive surgery.
- Salpingectomy
- Removal of the tube alone, with the ovary kept.
- Benign
- Not cancer.
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Side by side
How does removing only the tubes compare with removing tubes and ovaries?
Tubes only (salpingectomy)
Tubes and ovaries (BSO)
Ovaries keep making hormones, so no early menopause
Menopause starts at once if not already reached
Lowers risk from the tube, but the ovaries remain
Lowers risk from both tubes and ovaries
For gene carriers, still being studied as a first step
For gene carriers, the standard advice once childbearing is done
Natural pregnancy is no longer possible, though IVF may be
Pregnancy only with donor or frozen eggs, if the womb is kept
Commonly believed
What do people often believe about removing the tubes?
"The tubes make hormones, so removing them causes
menopause."
The tubes make no hormones. Menopause after this operation comes from removing the ovaries. When only the tubes are removed and the ovaries kept, periods and hormones usually carry on.
"Taking the tubes too makes it a much bigger
operation."
The tube is attached to the ovary and is usually removed with it in one step. It adds very little time or risk. Ask your surgeon if you want to know how it is done in your case.
"With tubes and ovaries gone, there is no risk left
at all."
A small risk remains of a similar cancer starting in the lining of the abdomen, called the peritoneum. That is why follow-up continues and new symptoms should still be reported.
"Having my tubes tied years ago did the same
job."
Tying or clipping the tubes blocks them but leaves the tube tissue in place. Removing them takes that tissue away. Tell your surgeon if you have had a sterilisation before.
Being straight with you
What can this page not tell you, and what should you ask?
This page explains why tubes are removed. It cannot tell you whether your own tubes or ovaries should be removed, when, or what the report will find. Those depend on your gene result, family history, age, plans for children and scans.
Questions for the surgeon
Will my tubes be removed, and will my ovaries be kept or removed too? If I have a gene fault, is removing the tubes first an option for me, or only within a trial? How will the tubes be examined after surgery?
Questions for the genetic counsellor
What is my own risk, given my gene and my family? Would delaying ovary removal change that risk? Which relatives should be offered testing?
If something is found
Ask who will explain the report and what the next step would be. Early findings in a preventive specimen are uncommon, and when they happen the team plans the next step carefully with you.
If you are unsure whether your planned operation includes the tubes, call the helpline and we will help you read the form.Questions we are asked
Common questions about removing the fallopian tubes
Does removing the tubes cause menopause?
No. The tubes make no hormones. If only the tubes are removed and the ovaries are kept, your periods and hormone levels usually carry on as before. Menopause after this kind of surgery comes from removing both ovaries, not from removing the tubes.
If my ovaries are coming out anyway, why does it matter?
Because early cancer changes can start in the tube, and leaving it would leave that tissue in the body. Once the ovaries are gone, the tube has no job left. Removing both together is quick and lets the lab examine the tubes closely.
Can I keep my ovaries and just have the tubes removed?
For many women having a hysterectomy or sterilisation for other reasons, yes, and it is now commonly offered. For BRCA carriers, removing the tubes first and the ovaries later is being studied but is not yet standard. Ask your team whether it is an option for you.
Will I still be able to have children?
Without tubes, natural pregnancy is not possible, because the egg cannot reach the womb. If the ovaries and womb are kept, IVF may still be possible. If both ovaries are also removed, pregnancy would need donor or frozen eggs. Raise plans for children before surgery.
What is STIC, and should I worry if it is on my report?
STIC means very early abnormal cells in the lining of the tube, found by careful examination. It is uncommon. If it is found, your surgeon will explain what it means and whether further tests or treatment are advised. Do not try to read it alone; ask for an appointment.
Does removing the tubes lower breast cancer risk?
No. The tubes have no effect on breast cancer risk. Breast screening should continue as your team has advised, especially if you carry a BRCA fault. Any effect on breast risk comes from removing the ovaries before menopause, and it does not replace screening.
Does it make recovery longer?
Usually not. The tube is removed together with the ovary, through the same keyhole cuts, in the same operation. Recovery is about the same as for removing the ovary alone. Your surgeon can tell you whether anything about your case makes the operation longer.
I had my tubes tied years ago. Do they still need removing?
Tubes that were tied or clipped are still in the body, so the tissue can still be examined and removed. Tell your surgeon about any earlier sterilisation or pelvic surgery, because scarring can change how the operation is done.
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Sources
- National Cancer Institute — Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Prevention (PDQ) - Patient Version
- National Cancer Institute — BRCA Gene Changes: Cancer Risk and Genetic Testing
- Cancer Research UK — Ovarian cancer risks and causes
- Cancer.Net — Ovarian, Fallopian Tube, and Peritoneal Cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
What Salpingo-Oophorectomy MeansThe name for removing the tube and ovary togetherRisk-Reducing Salpingo-Oophorectomy for BRCA CarriersPreventive surgery for inherited gene faultsOccult Cancer Found in a Preventive SpecimenWhat happens if the report finds somethingOne Ovary or Both: What DecidesWhat the team weighs about the ovaries themselvesThe Pathology Report After SurgeryHow to read the lab report after surgery
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