TAH/BSO (Total Abdominal Hysterectomy With Bilateral Salpingo-Oophorectomy)

Written by Rachel Reiff Ellis
Medically Reviewed by Traci C. Johnson, MD on February 26, 2025
9 min read

A total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH/BSO) is a surgery that removes your uterus, cervix, fallopian tubes, and ovaries. 

Salpingo-oophorectomy infographic

You can break down the definition of a TAH/BSO into parts to better understand what’s happening:

  • Total. Doctors use “total” to describe this surgery as a way to set it apart from a “radical” hysterectomy. A total hysterectomy removes your uterus and cervix. A radical hysterectomy removes all the same things a total hysterectomy does, but also takes away the upper portion of your vagina and some surrounding tissue and lymph nodes. 
  • Abdominal. A surgeon will do the surgery through a cut (incision) in your belly area (abdomen).
  • Hysterectomy. This is the term for surgery that removes your uterus. 
  • Bilateral. This means both sides. The surgery removes your ovaries on both sides of your body.
  • Salpingo. A salpingectomy is a procedure that removes your fallopian tubes, the tubes that connect your ovaries to your uterus. 
  • Oophorectomy. An oophorectomy is the removal of your ovaries. A salpingo-oophorectomy combines salpingectomy and oophorectomy, meaning a surgeon removes both your fallopian tubes and your ovaries.

After you have a TAH/BSO, you’ll enter menopause (no longer have periods), if you haven’t already. You’ll also no longer be able to get pregnant.

Often doctors try other nonsurgical treatments for the issues a TAH/BSO addresses before turning to TAH/BSO. But when these treatments don’t work, surgery may be the only option. Several conditions may need treatment with TAH/BSO, including:

  • Fibroids in your uterus
  • Endometriosis, a painful condition where uterine tissue grows outside the uterus
  • Pelvic inflammatory disease (PID) that hasn’t gotten better with treatment
  • Heavy periods, especially if uterine fibroids are the cause
  • Adenomyosis, a condition where the inner lining of the uterus (endometrium) grows into the muscle wall of the uterus
  • Uterine prolapse, a condition where the ligaments that hold the uterus weaken and it drops down into your vagina
  • Cancer, specifically cancer of the uterus, cervix, or ovaries
  • Complications of childbirth, such as uterine rupture
  • Gender confirmation surgery for people who want to better align their body with their gender identity 

A TAH/BSO can help improve your quality of life, especially if you’re living with constant pain and bleeding. Having the surgery also lowers your risk of uterine cancer, and removing your fallopian tubes and ovaries reduces your risk of ovarian cancer. 

“Fibroids causing pain or heavy bleeding are the most common reason people undergo TAH/BSO,” says Sarah Kim, MD, a gynecologic surgeon at Memorial Sloan Kettering Cancer Center. 

TAH/BSO is a major surgery. Your doctor will be sure you know what’s in store beforehand so you can be ready for it. Be sure to ask questions about your clinic’s rules and procedures so you feel comfortable and informed.

Preparing for TAH/BSO

You’ll meet with your surgeon to go over the procedure, risks, and benefits. You’ll also need testing before the surgery to look for cancer or other issues. Your surgeon will use this information to decide the best way to approach your surgery.

 These tests may include:

  • A Pap test to look for irregular cervical cells 
  • Biopsy of your endometrium (lining of the uterus) to look for irregular cells  
  • Ultrasound of your pelvis to look for uterine fibroids, endometrial polyps, or ovarian cysts 
  • Blood and urine tests to see if you have any conditions that could affect surgery 
  • Magnetic resonance imaging (MRI) and computed tomography (CT) scans of your pelvis and abdomen to look at the organs, tissues, and structures there 

Your medical team may give you a special antibacterial soap to wash with the day before your surgery to lower your risk of infection. 

As is the case with most major surgeries, you’ll need to stop drinking and eating after midnight the night before your surgery. You’ll be under general anesthesia during it, so you’ll also need someone who can drive you to and from the appointment. 

TAH/BSO surgery procedure

You’ll wear a hospital gown for the surgery, and someone on your medical team will hook you up to an IV for fluids and medication. You’ll also be connected to machines that monitor your heart rate. You may also have a catheter during and after the surgery, which is a thin tube inserted through your urethra into your bladder to empty urine. 

An anesthesiologist will give you general anesthesia so you’re asleep during surgery and can’t feel anything. While you’re under anesthesia, your surgeon will:

  • Clean the area 
  • Make a cut vertically or horizontally (similar to a C-section cut) low on your abdomen 
  • Detach and remove your uterus, fallopian tubes, ovaries, and cervix 
  • Stitch up the opening 

Surgery typically takes about two to four hours. 

TAH/BSO recovery

You can expect to be in the hospital for an average of two to five days after your TAH/BSO. During that time, your medical team will check your pain levels and help you start you moving, eating, and drinking slowly. They’ll also watch for any potential complications from surgery.

Full recovery takes about six to eight weeks. Your doctor will prescribe antibiotics to prevent infection and pain medications. You’ll need to take it easy as you recover at home. 

“The main activity restrictions are no heavy lifting and nothing inside the vagina for six to eight weeks,” says Kim. “Providers may have specific restrictions, so you should ask your doctor.”

Right after surgery, you may have some discomfort in your belly. Typically, TAH/BSO causes some bleeding and discharge from your vagina for about one to two weeks after surgery. These should slowly decrease and then stop. It’s possible you could have pink, brown, or yellow-brown discharge for four to six weeks. 

The site of your incision may be red and bruised, which will go away over time. Depending on how your doctor closed your incision, you may have to have stitches or staples removed. 

It’s common to feel a sense of loss and sadness after TAH/BSO. Since the surgery takes away the ability to have children and stops periods, it can feel like a major shift in your life. In some cases, TAH/BSO can increase the risk of depression. Connecting with others who’ve also gone through the surgery can be helpful.

TAH/BSO is a safe procedure, but any major surgery comes with risks. Infection is always a possibility, and you could bleed more than you should during surgery, or you could form blood clots. Some people have a bad reaction to the anesthesia. It’s possible that some of the structures around the area, such as your urinary tract, bladder, or rectum, could get damaged. You may need surgery to fix these problems. 

Long-term effects of TAH/BSO

Studies on the long-term effects of hysterectomy are ongoing, but research shows there may be a link between having a hysterectomy and:

  • Heart attack, stroke, and other problems with your heart and blood vessels
  • Certain cancers
  • The need for further surgery
  • Early ovarian failure and menopause
  • Depression

Certain symptoms after a TAH/BSO are a sign of a problem, and your doctor needs to know about them right away. These include:

  • Bright red blood coming from your vagina
  • Fever over 100 F
  • Severe nausea or vomiting
  • Problems peeing, such as a burning feeling or peeing very often
  • Increasing redness, swelling, or drainage from your incision site
  • Pain that gets worse instead of better

Anyone with a uterus who has a TAH/BSO will have changes in their hormones after the surgery. Along with directing your menstrual cycle, the hormones your ovaries produce are important for brain, bone, and cardiac health.

“If you’re already in menopause prior to undergoing TAH/BSO, most likely you won’t notice any changes hormonally. Although rarely, some postmenopausal patients experience brief recurrence of their hot flashes,” says Kim. 

Surgical menopause after TAH/BSO

Your ovaries produce progesterone and estrogen, so once they’re gone, these hormone levels are suddenly very low. This can cause menopause symptoms for people who were still having periods before the surgery. This is called “surgical menopause.”

Because surgical menopause happens suddenly, it can cause more severe symptoms than natural menopause that happens gradually. You’ll likely have:

  • Mood changes
  • Hot flashes
  • Trouble sleeping
  • Vaginal dryness
  • Problems with memory and concentration

Over time, the hormone changes of menopause can also affect your bone health and heart health. Your doctor can help you with treatments for these issues. Most commonly, hormone replacement therapy can introduce estrogen back into your body and decrease the effects, although this treatment isn’t for everyone. 

You and your doctor will weigh the risks and benefits carefully before you decide to go forward with a TAH/BSO. You’ll consider:

  • How severe your symptoms are and how they affect your quality of life
  • Whether there are other treatments for your issues
  • The hormonal impact of removing your ovaries 

It’s important to ask your doctor about how a TAH/BSO could affect you personally, so you can make the best decision for you. You can ask:

  • Are there other treatments I can try for my problem before a TAH/BSO?
  • Am I a candidate for a laparoscopic approach instead of a TAH/BSO?
  • What will recovery look like for me?
  • What treatments can help me with the hormonal side effects of the surgery?
  • How many TAH/BSO procedures have you done?
  • If you were in my position, would you have a TAH/BSO?

Depending on the issue you’re treating with a TAH/BSO, there may be other options. For some issues, especially cancer, a TAH/BSO is the best or only option. 

  • For heavy bleeding during periods, an intrauterine device (IUD) may help reduce flow. 
  • Uterine fibroids may get better with uterine artery embolization, a procedure that cuts off blood flow to the fibroids.
  • Endometrial ablation, a procedure that destroys the lining of the uterus, may help stop heavy bleeding. 
  • Lupron or contraceptives are medications that may also help relieve heavy bleeding.
  • A total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH/BSO) is a surgery that removes your uterus, cervix, fallopian tubes, and ovaries. 
  • You may need it to treat conditions such as fibroids, endometriosis, or cancer, or to align your body with your gender identity. 
  • A TAH/BSO is a major surgery, and you’ll be under general anesthesia during it. You’ll stay in the hospital for a few days, and total recovery takes about six to eight weeks. 
  • A TAH/BSO can cause hormonal changes, surgical menopause, and emotional effects, but it can improve quality of life by reducing pain and cancer risks.

What's the difference between a hysterectomy and a TAH/BSO?

Hysterectomy is the term that means removal of the uterus. A TAH/BSO removes more than the uterus. It’s a surgery that removes the uterus, ovaries, fallopian tubes, and cervix.

What happens to a woman’s body after a TAH/BSO?

After a TAH/BSO, you’re no longer able to get pregnant, because you don’t have eggs or a womb to grow a baby. The hormones your reproductive system made are now at drastically lower levels, which can cause surgical menopause if you haven’t already stopped having your period. This can cause symptoms such as hot flashes, vaginal dryness, mood changes, and trouble sleeping. A TAH/BSO can greatly improve quality of life for people who were having pain and heavy bleeding.

Will my stomach get bigger after a TAH/BSO?

The surgery can cause bloating and swelling, but this will go away. Your organs will rearrange slowly to fill the space that’s left after your reproductive organs are gone.