Our Summary

This research paper states that when women undergo pelvic surgery for non-cancerous conditions, removing the fallopian tubes can help reduce their risk of ovarian cancer. This procedure, called an opportunistic salpingectomy, can be done during other surgeries like a hysterectomy. However, it does not completely eliminate the risk of ovarian cancer. Women should be informed about the risks and benefits of this procedure. This may include discussing the role of oophorectomy (removal of the ovaries) and bilateral salpingo-oophorectomy (removal of both fallopian tubes and ovaries). The latter can reduce the risk of ovarian cancer even more, but can also lead to other health issues like heart disease, other types of cancer, osteoporosis, cognitive impairment, and even increased risk of death. The paper also mentions that removing the fallopian tubes does not seem to affect ovarian function and does not increase the risk of complications like blood transfusions, rehospitalisation, infections, or fever. The researchers advise doctors to continue using minimally invasive techniques and to keep the intended route of hysterectomy unchanged if planning to perform an opportunistic salpingectomy. The paper has been updated with new information on the benefits of salpingectomy for cancer reduction, its feasibility during vaginal hysterectomy, and long-term follow-up of women after the procedure.

FAQs

  1. What is an opportunistic salpingectomy and how does it reduce the risk of ovarian cancer?
  2. Does removing the fallopian tubes during a salpingectomy procedure affect ovarian function or increase the risk of complications?
  3. What are the potential risks and benefits associated with bilateral salpingo-oophorectomy?

Doctor’s Tip

A doctor might advise a patient considering bilateral tubal ligation to also discuss the option of having an opportunistic salpingectomy during the procedure to reduce their risk of ovarian cancer. They should be informed about the risks and benefits of this additional procedure, including the potential impact on ovarian function and the possibility of other health issues. It is important for the patient to have a thorough discussion with their doctor to make an informed decision that is right for their individual health needs.

Suitable For

Patients who are typically recommended bilateral tubal ligation include:

  1. Women who have completed their desired family size and are looking for a permanent form of contraception.

  2. Women who have a high risk of ovarian cancer, such as those with a family history of the disease or certain genetic mutations.

  3. Women undergoing pelvic surgery for non-cancerous conditions, who may benefit from an opportunistic salpingectomy to reduce their risk of ovarian cancer.

  4. Women who are at risk of ectopic pregnancy, as tubal ligation can help reduce the risk of this potentially dangerous condition.

  5. Women with certain medical conditions that make pregnancy risky, such as severe heart disease or certain genetic disorders.

It is important for patients to discuss their individual risk factors and medical history with their healthcare provider to determine if bilateral tubal ligation is the right choice for them.

Timeline

  • Patient consults with their healthcare provider to discuss the possibility of undergoing bilateral tubal ligation as a form of permanent contraception
  • Patient undergoes pre-operative assessments and evaluations to ensure they are a suitable candidate for the procedure
  • Patient schedules a date for the surgery and receives instructions on how to prepare for the procedure
  • Patient undergoes bilateral tubal ligation surgery, which can be performed through laparoscopy or mini-laparotomy
  • After the surgery, the patient may experience some mild discomfort, bloating, and fatigue
  • Patient is advised to rest and avoid strenuous activities for a few days following the surgery
  • Patient may experience some spotting or light bleeding for a few days post-surgery
  • Patient attends a follow-up appointment with their healthcare provider to ensure proper healing and discuss any concerns or questions
  • Patient resumes normal activities and enjoys the peace of mind that comes with permanent contraception
  • Patient continues to have regular check-ups with their healthcare provider to monitor their overall health and well-being

What to Ask Your Doctor

  1. What are the risks and benefits of bilateral tubal ligation for me specifically?
  2. How will bilateral tubal ligation affect my risk of ovarian cancer?
  3. Are there any long-term health risks associated with bilateral tubal ligation?
  4. How will bilateral tubal ligation impact my fertility and hormone levels?
  5. Are there alternative options for contraception that I should consider?
  6. What is the recovery process like after bilateral tubal ligation?
  7. Will I need any follow-up appointments or tests after the procedure?
  8. Are there any lifestyle changes I should make after undergoing bilateral tubal ligation?
  9. How often should I have screenings for ovarian cancer after bilateral tubal ligation?
  10. Are there any potential complications or side effects I should be aware of?

Reference

Authors: [No authors listed] Journal: Obstet Gynecol. 2019 Apr;133(4):842-843. doi: 10.1097/AOG.0000000000003165. PMID: 30913193