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Gynecology & Reproductive Sciences

STUDY: Doctors No Longer Have to Remove Ovaries During a Hysterectomy

surgery

A relatively new study has found that women do not have to lose their ovaries during non-cancerous surgeries involving removal of a woman’s reproductive system.

Traditionally, during hysterectomies to treat benign conditions, doctors remove the Fallopian tubes and the ovaries in order to reduce the patient’s ovarian cancer risk. Doing this maneuver actually induces early menopause and lowers a woman’s libido.

However, according to Yale School of Medicine research, ovarian cancer often originates in the Fallopian tube and not the ovaries, and thus removal of the ovaries may not be necessary.

This could mean a woman can possibly produce an offspring from her eggs (using the magic of modern medicine) even after having a hysterectomy. This is good news for younger women who’ve had to have the procedure done.

Assistant professor in Department of Obstetrics, Gynecology & Reproductive Sciences at Yale School of Medicine Xiao Xu published the results of the study in the February issue of the journal Obstetrics & Gynecology.

In fact,  her team’s findings were backed  by American College of Obstetricians and Gynecologists (ACOG) which issued a statement in 2015 suggesting  bilateral salpingectomy with ovarian conservation — surgical removal of both Fallopian tubes while retaining the ovaries — may be a better option for ovarian cancer prevention in women at low risk for ovarian cancer.

Using data from the 2012 National Inpatient Sample, Xu and her co-author, Vrunda Bhavsar Desai, M.D. studied 20,635 adult women undergoing hysterectomy for benign conditions who were at low risk for ovarian cancer or future ovarian surgery.

“We found that among women undergoing inpatient hysterectomies in 2012 who were at low risk for ovarian cancer, very few of them received bilateral salpingectomy  with preservation of the ovaries,” Xu said. “The rate of bilateral salpingectomy with ovarian conservation was 5.9% in this population.

Not enough doctors are providing this option to their patients but this study could help establish a baseline.

Xu added that the rate of bilateral salpingectomy with ovarian conservation varied widely among 744 hospitals across the country, ranging from 0% to 72.2%.

“The wide variation in hospital practice may result in differential access to prophylactic procedures depending on where patients access care,” said Xu. “This can have longer-term health implications given the benefits of ovarian conservation.”

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