Time Of Benign Hysterectomy Research Articles

Implementation Rate of Risk-Reducing Salpingectomy at Time of Benign Hysterectomy

Implementation Rate of Risk-Reducing Salpingectomy at Time of Benign Hysterectomy

Salpingo-oophorectomy at the Time of Benign Hysterectomy: A Systematic Review.

To compare the long-term risks associated with salpingo-oophorectomy with ovarian conservation at the time of benign hysterectomy. MEDLINE, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials were searched from inception to January 30, 2015. We included prospective and retrospective comparative studies of women with benign hysterectomy who had either bilateral salpingo-oophorectomy (BSO) or conservation of one or both ovaries. Reviewers double-screened 5,568 citations and extracted eligible studies into customized forms. Twenty-six comparative studies met inclusion criteria. Studies were assessed for results, quality, and strength of evidence. Studies were extracted for participant, intervention, comparator, and outcomes data. When compared with hysterectomy with BSO, prevalence of reoperation and ovarian cancer was higher in women with ovarian conservation (ovarian cancer risk of 0.14-0.7% compared with 0.02-0.04% among those with BSO). Hysterectomy with BSO was associated with a lower incidence of breast and total cancer, but no difference in the incidence of cancer mortality was found when compared with ovarian conservation. All-cause mortality was higher in women younger than age 45 years at the time of BSO who were not treated with estrogen replacement therapy (hazard ratio [HR] 1.41, 95% confidence interval [CI] 1.04-1.92). Coronary heart disease (HR 1.26, 95% CI 1.04-1.54) and cardiovascular death were higher among women with BSO (HR 1.84, 95% CI 1.27-2.68), especially women younger than 45 years who were not treated with estrogen. Finally, there was an increase in the prevalence of dementia and Parkinson disease among women with BSO compared with conservation, especially in women younger than age 50 years. Clinical practice guidelines were devised based on these results. Bilateral salpingo-oophorectomy offers the advantage of effectively eliminating the risk of ovarian cancer and reoperation but can be detrimental to other aspects of health, especially among women younger than age 45 years.

19: Rates of inappropriate oophorectomy at the time of benign hysterectomy

19: Rates of inappropriate oophorectomy at the time of benign hysterectomy

Editorial introductions

Editorial introductions

Surgical Outcomes and Complications of Prophylactic Salpingectomy at the Time of Benign Hysterectomy in Premenopausal Women

To compare the surgical outcome and short-term postoperative complications in premenopausal women who had undergone hysterectomies for benign indication with or without prophylactic bilateral salpingectomy. A cohort of consecutive women who had undergone hysterectomy plus bilateral salpingectomy between May 2012 and July 2014 (group A) were compared with the same number of consecutive premenopausal patients who had undergone simple hysterectomy operated on before May 2012 (group B). Inclusion criteria included premenopausal women and benign indication for surgery (Canadian Task Force classification III). tertiary care hospital. Salpingectomy versus no salpingectomy at the time of benign hysterectomy. A total of 97 and 71 patients were included in groups A and B, respectively. No differences between the 2 groups were observed regarding patient characteristics. The average operative time, estimated blood loss, uterine size, and intraoperative complications were similar between groups. The mean (standard deviation) length of hospitalization time was 43.7 (22.4) hours in group A and 53.9 (83.5) hours in group B (p = .008). There were no significant differences in terms of the incidence of postoperative complications, emergency visits after readmission, and hospital readmission between both groups of patients. Prophylactic salpingectomy at the time of benign hysterectomy in premenopausal women is safe and feasible and does not worsen surgical outcomes or the incidence of intraoperative and postoperative complications.

Risk-Reducing Salpingectomy with Benign Hysterectomy and Permanent Sterilization: A Survey of Obstetrician–Gynecologists

Abstract Objective: The goal of this research was to determine the willingness among obstetrician–gynecologists to offer risk-reducing salpingectomy at the time of benign hysterectomy or permanent sterilization. Materials and Methods: A voluntary and anonymous survey survey was administered to obstetrician–gynecologists at an urban academic and affiliated community hospital in 2012. The survey assessed provider demographics and knowledge about ovarian cancer prevention. Providers were then given a brief summary of the emerging data that ovarian cancer may emerge from Fallopian tubes and were surveyed on willingness to offer risk-reducing salpingectomy at the time of hysterectomy or permanent sterilization to patients who would otherwise undergo ovarian conservation. Results: Ninety-one providers completed the survey (75% response rate). Significantly more physicians were willing to offer risk-reducing salpingectomy at the time of hysterectomy rather than at the time of permanent sterilization (96% versus ...

Risk-reducing salpingectomy at the time of benign gynecologic surgery: A survey of ACOG members in New York State.

1573 Background: To determine if Obstetricians and Gynecologists in New York state would offer risk-reducing salpingectomy (RRS) at the time of benign hysterectomy with ovarian preservation or perm...

AAGL Practice Report: Practice Guidelines on the Prevention of Apical Prolapse at the Time of Benign Hysterectomy

Pelvic organ prolapse may adversely impact physical, sexual and emotional health. Women with symptomatic prolapse often experience altered bladder and bowel function, increased pelvic pressure, diminution of sexual satisfaction, and altered body image. With increasing vaginal descent, various bladder, bowel, and prolapse symptoms are increased. Approximately 200,000 women undergo inpatient procedures for prolapse in the United States each year, with regional and racial differences in rates of surgery reported. The demand for health care services related to pelvic floor disorders will increase at twice the rate of the population itself.

Risk factors for lower urinary tract injury at the time of hysterectomy for benign reasons

To identify risk factors associated with lower urinary tract injury at the time of performing hysterectomy for benign indications. We conducted a multi-center case-control study of women undergoing hysterectomy for benign disease. Cases were identified via ICD-9 codes for lower urinary tract injury at the time of hysterectomy from 2007 to 2011: controls were two subsequent hysterectomies following the index case in the same institution that did not have lower urinary tract injury. Logistic regression was used to perform univariate and multivariate comparisons between groups. At 7 centers, 135 cases and 270 controls were identified. Cases comprised 118 bladder injuries and 25 ureteral injuries; 8 women had both bladder and ureteral injury. Bladder injury was associated with a history of prior cesarean section OR 2.9 (95% CI 1.7-5), surgery by a general obstetrician and gynecologist OR 2.4 (95% CI 1.2-5.2), and total abdominal hysterectomy OR1.9 (95%CI 1.06-3.4). Ureteral injury was more likely among women who underwent laparoscopic-assisted vaginal hysterectomy (LAVH) OR 10.4 (95%CI 2.3-46.6) and total abdominal hysterectomy (TAH) OR 4.7 (95% CI 1.4-15.6). Bladder injury at the time of benign hysterectomy is associated with a prior history of Cesarean section and TAH as well as surgery by generalist OB-GYN; ureteral injury is associated with LAVH and TAH.

Adnexectomy Versus Ovarian Conservation During Total Hysterectomy for Benign Conditions. A Difficult Dilemma

Introduction: Bilateral adnexectomy is a surgical procedure that is frequently associated with total hysterectomy performed for benign uterine conditions. Given the relatively wide range of indications for the aforementioned type of salpingo-ooforectomy which in it self is not devoid of potential risks the patients' and physicians' decision-making should take into account several parameters (most helpful to individualize treatment) such as published ratio of removal versus conservation of uterine adnexae, patients' age, pre/postmenopausal status at the time of surgery, relevant family and personal history including current use of hormonal replacement therapy. Materials and Methods: This retrospective cohort study was conducted among 457 women aged 18 years or older who underwent abdominal total hysterectomies for benign uterine conditions between 2000 and 2011. The study patients were stratified by age for better characterization and according to recent publications. Results: Uni- or bilateral oophorectomy was performed in 50% of the subgroup of hysterectomized women younger than 35 years old whereas in the other half of the same age category of patients the uterine adnexas were conserved. Among the study patients aged between 35 and 45 years in 50.5% of the cases the unilateral type of oophorectomy was undertaken while for the other 49.5% of women the bilateral adnexectomy was the rule. Finally, in all patients older than age 45 years the bilateral salpingo-oophorectomy was the procedure of choice. Moreover, out of the 55 study patients in which at least one ovary was preserved, 30.9% of cases underwent the removal of the remaining adnexa when affected de novo by malignant (n=3) or benign (n=14) pathology. Last but not least, in order to reduce both cancer risks and early menopause hazards, our analysis based on recent literature attempted to identify patient characteristics (relevant factors) associated with or without bilateral oophorectomy at the time of benign hysterectomy and to estimate modern trends in the performance of oophorectomy. Conclusion: When considering options for treatment of benign conditions of the uterus both physicians and patients should ponder carefully the risk/benefit ratio of salpingo-oophorectomy according to each patient clinical profile.

Risk-reducing salpingectomy at the time of benign hysterectomy and permanent sterilization: A survey of obstetricians/gynecologists

Risk-reducing salpingectomy at the time of benign hysterectomy and permanent sterilization: A survey of obstetricians/gynecologists

Drop in Oophorectomies at the Time of Benign Hysterectomy

Drop in Oophorectomies at the Time of Benign Hysterectomy

Change in Performance of Oophorectomy at the Time of Benign Hysterectomy

Study Objective: To assess the change in the rate of oophorectomy performed at the time of hysterectomy before and after the publishing of the results of the Nurses' Health study in May 2009 indicating increased mortality, coronary heart disease and lung cancer associated with bilateral oophorectomy performed at the time of hysterectomy.