Menopausal Symptoms and Surgical Complications After Opportunistic Bilateral Salpingectomy, A Register-based Cohort Study

Collins, Elin; Strandell, Annika; Granåsen, Gabriel; Idahl, Annika

doi:10.1097/01.ogx.0000552984.13266.aa

Cited by 2 publications

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“…There has been some suggestion that salpingectomy may diminish AMH levels leading to an earlier age at menopause, although this has yet to be demonstrated 59 . A recent Swedish registry‐based study reported a significant increase in menopausal symptoms 1‐year following salpingectomy with hysterectomy ( n = 1,433) versus hysterectomy alone ( n = 3,473) (relative risk = 1.33; 95% CI 1.04–1.69) 61 . To our knowledge, there have been no other large‐scale prospective studies evaluating the long‐term impact of salpingectomy on ovarian function or other outcomes, especially among women who are premenopausal at the time of surgery.…”

Section: Preventing Ovarian Cancer With Salpingectomy Among Women In mentioning

confidence: 99%

Prophylactic salpingectomy for the prevention of ovarian cancer: Who should we target?

Kotsopoulos

Narod

2020

Intl Journal of Cancer

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Ovarian cancer is the most fatal gynecologic malignancy (50% 5‐year survival) due to a typically advanced stage at diagnosis and a high rate of recurrence. Chemoprevention options are limited, and few interventions have been shown to reduce cancer risk or mortality. Emerging data support the model that fallopian tubes are the site of origin for a proportion of high‐grade serous cancers. This implies that a subset of cancers may be prevented by removing the fallopian tubes while leaving the ovaries intact. Accordingly, there has been shift in clinical practice for average risk women; some now recommend removal of both the fallopian tubes only instead of tubal ligation for sterilization or at the time of benign gynecologic surgery. This has been termed opportunistic salpingectomy and represents a means of decreasing the burden of ovarian cancer by preventing cancers that arise in the fallopian tubes. There have been no detailed, prospective reports that have estimated ovarian cancer risk reduction with opportunistic salpingectomy, neither among women at baseline population risk nor among women at a high risk of developing the disease. The situation is complicated for women with a BRCA mutation—bilateral salpingo‐oophorectomy is a proven means of risk reduction and salpingectomy alone is not the standard of care. Based on the existing data, salpingectomy alone should only be reserved for women with a lifetime risk of ovarian cancer of less than 5%.

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Section: Preventing Ovarian Cancer With Salpingectomy Among Women In mentioning

confidence: 99%

Prophylactic salpingectomy for the prevention of ovarian cancer: Who should we target?

Kotsopoulos

Narod

2020

Intl Journal of Cancer

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“…Therefore, it is reasonable to consider that prophylactic bilateral salpingectomy may prevent ovarian cancer without the risk of premature menopause. However, other studies have found that bilateral salpingectomy alone or combined with hysterectomy could increase the risk of menopausal symptoms or decrease the antral follicle count (AFC) after surgery [10,11]. Patients are understandably concerned about the effects of bilateral salpingectomy, but relatively few studies have been conducted in China to assess the risks and bene ts of the procedure.…”

Section: Introductionmentioning

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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Menopausal Symptoms and Surgical Complications After Opportunistic Bilateral Salpingectomy, A Register-based Cohort Study

Abstract: Access to the published version may require subscription. N.B. When citing this work, cite the original published paper.

Cited by 2 publications

References 24 publications

Prophylactic salpingectomy for the prevention of ovarian cancer: Who should we target?

Prophylactic salpingectomy for the prevention of ovarian cancer: Who should we target?

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

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