Our Summary

This study looked at how often a specific type of surgery was successful when performed at the same time as another procedure. The surgery in question is a bilateral salpingo-oophorectomy, which is the removal of both ovaries and fallopian tubes. This was done during a vaginal hysterectomy (a procedure to remove the uterus) in women who had pelvic organ prolapse (a condition where the organs in the pelvis drop due to weak supportive muscles).

The researchers examined medical records from 453 patients between 2014 and 2019. They found that the success rate for removing the ovaries and tubes was 57.9% overall. However, when the patients had agreed to “extraordinary measures” (more invasive procedures), the success rate was 93.9%, compared to 55% in those who only agreed to the procedure “if possible”.

The study also found that the surgery was more likely to be successful if another procedure (a posterior repair) was carried out at the same time. The surgery took longer when the removal of the ovaries and tubes was successful, adding about 14 minutes to the operation time.

Patients in the successful group were more likely to have a family history of ovarian cancer, a personal history of breast cancer, or a strong desire to have their ovaries and tubes removed.

Overall, the study suggests that the determination of the surgeon to complete the procedure seems to have a significant impact on its success.

FAQs

  1. What is a bilateral salpingo-oophorectomy and when is it performed?
  2. What factors were found to increase the success rate of a bilateral salpingo-oophorectomy?
  3. What impact does the determination of the surgeon have on the success rate of the procedure according to the study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about salpingo-oophorectomy is to discuss their personal medical history, family history, and reasons for wanting the procedure with their surgeon. This information can help the surgeon determine the best approach and increase the likelihood of a successful outcome. Additionally, being open to additional procedures or “extraordinary measures” if necessary may improve the overall success rate of the surgery. It is important for patients to communicate openly with their healthcare provider and ask any questions they may have about the procedure.

Suitable For

Patients who are typically recommended salpingo-oophorectomy include those with a family history of ovarian cancer, a personal history of breast cancer, or those who have a strong desire to have their ovaries and tubes removed. Additionally, patients with pelvic organ prolapse undergoing a vaginal hysterectomy may also be recommended for this procedure. The study also suggests that the success of the surgery may be influenced by the patient’s willingness to undergo more invasive procedures and the determination of the surgeon to complete the procedure.

Timeline

Before the salpingo-oophorectomy:

  • Patient undergoes initial consultation with a gynecologist to discuss symptoms and potential treatment options
  • Diagnostic tests may be conducted, such as imaging studies or blood tests
  • Surgery is scheduled after discussing risks and benefits with the healthcare provider

During the salpingo-oophorectomy:

  • Patient is put under general anesthesia
  • Surgeon makes incisions in the abdomen to access the ovaries and fallopian tubes
  • Ovaries and fallopian tubes are removed
  • Procedure may be combined with other surgeries or procedures, such as a hysterectomy or pelvic organ prolapse repair

After the salpingo-oophorectomy:

  • Patient is monitored in the recovery room before being discharged
  • Pain medication and instructions for post-operative care are provided
  • Follow-up appointments are scheduled to monitor healing and address any complications
  • Hormone replacement therapy may be prescribed to manage symptoms of menopause if both ovaries are removed

Overall, the patient may experience relief from symptoms related to conditions such as pelvic organ prolapse or ovarian cancer, but may also need to adjust to the hormonal changes that result from the removal of the ovaries. Close monitoring and ongoing care are important for the patient’s long-term health and well-being.

What to Ask Your Doctor

  1. What is the purpose of a bilateral salpingo-oophorectomy?
  2. What are the potential risks and complications associated with this surgery?
  3. How will this procedure affect my hormones and overall health?
  4. Are there any alternative treatments or procedures I should consider?
  5. What is the success rate of this surgery, especially when performed in conjunction with another procedure?
  6. What factors contribute to a successful outcome for this surgery?
  7. How long is the recovery process, and what can I expect in terms of pain and discomfort?
  8. Will I need hormone replacement therapy after the removal of my ovaries?
  9. Are there any long-term effects or complications I should be aware of?
  10. How often will I need follow-up appointments or monitoring after the surgery?

Reference

Authors: Messingschlager C, Ferrando CA, Chang OH. Journal: Eur J Obstet Gynecol Reprod Biol. 2023 Apr;283:54-58. doi: 10.1016/j.ejogrb.2023.01.033. Epub 2023 Feb 1. PMID: 36773471