Comparing surgical outcome and ovarian reserve after laparoscopic hysterectomy between two methods of with and without prophylactic bilateral salpingectomy

Asgari, Zahra; Tehranian, Afsaneh; Rouholamin, Safoura; Hosseini, Reihaneh; Sepidarkish, Mahdi; Rezainejad, Mahroo

doi:10.4103/0973-1482.193114

Cited by 17 publications

(15 citation statements)

References 19 publications

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“…Nonetheless, this mechanism is not universally accepted and the available data are conflicting. For example, some studies have found no evidence for loss of ovarian function after hysterectomy, whereas others showed that hysterectomy damages ovarian reserve . Therefore, based on the current evidence, it is unclear whether hysterectomy compromises ovarian reserve among premenopausal women …”

Section: Introductionmentioning

confidence: 91%

“…For example, some studies have found no evidence for loss of ovarian function after hysterectomy, 4,5 whereas others showed that hysterectomy damages ovarian reserve. [6][7][8] Therefore, based on the current evidence, it is unclear whether hysterectomy compromises ovarian reserve among premenopausal women. [9][10][11] Anti-Müllerian hormone (AMH) is a dimeric glycoprotein that belongs to the transforming growth factor β family of growth and differentiation factors.…”

Section: Introductionmentioning

confidence: 99%

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The effects of hysterectomy with bilateral salpingectomy on ovarian reserve

Yuan

Cao

et al. 2019

Intl J Gynecology & Obste

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Objective To determine whether ovarian reserve is compromised after hysterectomy with bilateral salpingectomy. Methods A prospective longitudinal study was conducted among 84 women who underwent hysterectomy with bilateral salpingectomy at a tertiary medical center in Beijing, China, between August 2, 2015, and January 15, 2017. Serum levels of anti‐Müllerian hormone (AMH) and follicle‐stimulating hormone (FSH) were measured to assess ovarian function before undergoing the procedure (baseline) and at weeks 1 and 6 after surgery (postoperative period). Results The median age was 41.61 ± 0.62 years. Age negatively correlated with the serum AMH level at baseline (P<0.001), as well as with preoperative‐to‐postoperative changes in the concentration of this hormone (P<0.001). Serum AMH levels were lower in the postoperative period versus the preoperative period (P<0.001). By contrast, serum FSH levels were higher in the postoperative period than in the preoperative period (P<0.001). Moreover, no correlation was found with body mass index. Conclusions Hysterectomy with bilateral salpingectomy compromised ovarian reserve, with the damage being most severe among younger patients.

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Section: Introductionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

The effects of hysterectomy with bilateral salpingectomy on ovarian reserve

Yuan

Cao

et al. 2019

Intl J Gynecology & Obste

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“…Moreover, in the laparoscopy group, the cause of decreasing AMH may be due to electrocauterization. A randomized trial of hysterectomy with or without salpingectomy also showed decreased AMH (from 1.44 to 1.13 ng/ml) after both kinds of surgeries [26]. However, we did not have data of the AMH of each woman in our database.…”

Section: Discussionmentioning

confidence: 87%

Hysterectomies are associated with an increased risk of osteoporosis and bone fracture: A population-based cohort study

Yeh

et al. 2020

PLoS ONE

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Aim This study investigated the risk of osteoporosis or bone fractures (vertebrae, hip and others) in hysterectomized women in Taiwan. Materials and methods This is a retrospective population-based cohort study from 2000 to 2013. Women aged ≥30 years who underwent hysterectomy between 2000 and 2012 were included in this study. The comparison group was randomly selected from the database with a 1:4 matching with age and index year. Incidence rate and hazard ratios of osteoporosis and bone fracture between hysterectomized women and the comparison group were calculated. Cox proportional hazard regressions were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Results We identified 9,189 hysterectomized women and 33,942 age-matched women without a hysterectomy. All women were followed for a median time of about 7 years. The adjusted hazard ratio (aHR) of subsequent osteoporosis or bone fracture was higher in the hysterectomy women (2.26, 95% confidence interval [CI] = 2.09–2.44) than in the comparison group. In the subgroup analysis, oophorectomy and estrogen therapy increase the risk of osteoporosis or fracture in both groups. Regarding the fracture site, the aHR of vertebral fracture (4.92, 95% CI = 3.78–6.40) was higher in the hysterectomized women than in the comparison group. As follow-up time increasing, the aHR of vertebral fracture in hysterectomized women were 4.33 (95% CI = 2.99–6.28), 3.89 (95% CI = 2.60–5.82) and 5.42 (95% CI = 2.66–11.01) for <5, 5–9 and ≥9 years of follow-up, respectively. Conclusions In conclusion, we found that hysterectomized women might be associated with increased risks of developing osteoporosis or bone fracture.

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“…It would be optimal to assess the effect of surgery on younger women, in whom ovaries have greater potential for follicle loss. However, younger patients are more likely to be concerned with maintaining reproductive ability and are less likely to undergo hysterectomy [24][25][26]. Further, delayed childbearing has increased in China in recent years and is very common globally [27,28].…”

Section: Discussionmentioning

confidence: 99%

The effect of prophylactic bilateral salpingectomy on ovarian reserve in patients who underwent laparoscopic hysterectomy

Wang

gu²

2021

Preprint

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Background Bilateral salpingectomy has been proposed to reduce the risk of ovarian cancer, but it is not clear whether the surgery affects ovarian reserve. This study compares the impact of laparoscopic hysterectomy for benign disease with or without prophylactic bilateral salpingectomy on ovarian reserve. Methods Records were reviewed for 373 premenopausal women who underwent laparoscopic hysterectomy with ovarian reserve for benign uterine diseases. The serum anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and three-dimensional antral follicle count (AFC) were assessed before surgery and 3 and 9 months postoperatively to evaluate ovarian reserve. Patients were divided into two groups according to whether they underwent prophylactic bilateral salpingectomy. The incidence of pelvic diseases was monitored until the ninth month after surgery. Results There was no significant difference between the two surgery groups in terms of baseline AMH, E2, FSH, LH, and AFC (all P > 0.05). There was no difference in potential bias factors, including patient age, operative time, and blood loss (all P > 0.05). There was also no significant difference between the two groups 3 months after surgery with respect to AMH (P = 0.763), E2 (P = 0.264), FSH (P = 0.478), LH (P = 0.07), and AFC (P = 0.061). Similarly, there were no differences between groups 9 months after surgery for AMH (P = 0.939), E2 (P = 0.137), FSH (P = 0.276), LH (P = 0.07) and AFC (P = 0.066). At 9 months after the operation, no patients had malignant ovarian tumors. The incidences of benign ovarian tumors in the salpingectomy group were 0% and 2.68% at 3 and 9 months after surgery, respectively, and the corresponding values in the control group were 0% and 5.36%. The incidences of pelvic inflammatory disease in the salpingectomy group were 10.72% and 8.04% at 3 and 9 months after surgery, respectively, while corresponding values in the control group were 24.13% and 16.09%. Conclusion Prophylactic bilateral salpingectomy did not damage the ovarian reserve of reproductive-age women who underwent laparoscopic hysterectomy. Prophylactic bilateral salpingectomy might be a good method to prevent the development of ovarian cancer. Larger clinical trials with longer follow-up times are needed to further evaluate the risks and benefits.

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Comparing surgical outcome and ovarian reserve after laparoscopic hysterectomy between two methods of with and without prophylactic bilateral salpingectomy

Cited by 17 publications

References 19 publications

The effects of hysterectomy with bilateral salpingectomy on ovarian reserve

The effects of hysterectomy with bilateral salpingectomy on ovarian reserve

Hysterectomies are associated with an increased risk of osteoporosis and bone fracture: A population-based cohort study

The effect of prophylactic bilateral salpingectomy on ovarian reserve in patients who underwent laparoscopic hysterectomy

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