Our Summary

This study looked at whether removing both ovaries and fallopian tubes (bilateral salpingo-oophorectomy) during a hysterectomy (removal of the uterus) for non-cancer reasons, affected the mortality rate of women. The researchers found that for women under 50, having the procedure increased the chance of death from any cause. However, for women aged 50 and over, the procedure did not significantly increase the chance of death. This suggests that caution should be used when considering this procedure for premenopausal women without a specific reason, while the procedure does not seem to harm survival rates in postmenopausal women.

FAQs

  1. What is bilateral salpingo-oophorectomy?
  2. Does undergoing bilateral salpingo-oophorectomy during a hysterectomy increase the mortality rate in women under 50?
  3. Is the bilateral salpingo-oophorectomy procedure harmful for postmenopausal women?

Doctor’s Tip

It is important to discuss the potential risks and benefits of salpingo-oophorectomy with your doctor, especially if you are under 50 years old. Consider seeking a second opinion before making a decision, as the procedure may have different implications based on your age and individual health factors.

Suitable For

Patients who are typically recommended salpingo-oophorectomy include those who have:

  1. A history of ovarian or fallopian tube cancer, or a strong family history of these cancers
  2. A high risk of developing ovarian or fallopian tube cancer, such as those with BRCA gene mutations
  3. Severe endometriosis or ovarian cysts that are causing significant symptoms or complications
  4. Pelvic inflammatory disease that has caused extensive damage to the ovaries or fallopian tubes
  5. Certain hormone-sensitive conditions, such as hormone-receptor-positive breast cancer, where removing the ovaries can help reduce the risk of recurrence
  6. Severe pelvic pain or chronic pelvic inflammatory conditions that have not responded to other treatments

It is important for patients to discuss the potential risks and benefits of salpingo-oophorectomy with their healthcare provider to determine if it is the best course of action for their individual situation.

Timeline

  • Initial consultation: The patient meets with their healthcare provider to discuss their medical history, symptoms, and the potential need for a salpingo-oophorectomy.
  • Pre-operative preparation: The patient undergoes pre-operative tests and evaluations to ensure they are healthy enough for surgery. They may also receive counseling and education about the procedure and its potential risks and benefits.
  • Surgery: The patient undergoes a salpingo-oophorectomy, during which both ovaries and fallopian tubes are removed. The surgery can be performed either laparoscopically or through an open abdominal incision.
  • Recovery: The patient spends time in the hospital recovering from surgery, which may involve pain management and monitoring for any complications.
  • Post-operative follow-up: The patient may have follow-up appointments with their healthcare provider to monitor their recovery and ensure that they are healing properly.
  • Long-term effects: After a salpingo-oophorectomy, the patient may experience menopausal symptoms, such as hot flashes, mood changes, and decreased libido. They may also be at an increased risk for certain health conditions, such as osteoporosis and heart disease, due to decreased estrogen levels.
  • Overall health outcomes: Research suggests that for women under 50, bilateral salpingo-oophorectomy may increase the risk of death from any cause. However, for women aged 50 and over, the procedure does not significantly impact survival rates. This highlights the importance of careful consideration and individualized decision-making when recommending this procedure.

What to Ask Your Doctor

  1. What are the specific reasons for recommending a salpingo-oophorectomy?
  2. What are the potential risks and complications associated with the procedure?
  3. How will the removal of both ovaries and fallopian tubes impact my hormone levels and menopausal symptoms?
  4. Are there alternative treatment options available that do not involve removing both ovaries and fallopian tubes?
  5. How will the procedure affect my overall health and quality of life in the long term?
  6. Will I need hormone replacement therapy after the surgery?
  7. How will the surgery impact my fertility and ability to have children in the future?
  8. What is the recovery process like after a salpingo-oophorectomy?
  9. Are there any lifestyle changes or precautions I should take after the surgery?
  10. Are there any specific follow-up appointments or screenings I should undergo after the procedure?

Reference

Authors: Cusimano MC, Chiu M, Ferguson SE, Moineddin R, Aktar S, Liu N, Baxter NN. Journal: BMJ. 2021 Dec 8;375:e067528. doi: 10.1136/bmj-2021-067528. PMID: 34880044