Opportunistic Salpingectomy Does Not Affect Ovarian Reserve or Surgical Outcomes in Patients Undergoing Laparoscopic Myomectomy

Abstract

Objective: To determine whether opportunistic salpingectomy in patients undergoing laparoscopic myomectomy has any deleterious effects on ovarian reserve and surgical risk. Study Design: We performed a retrospective review of patients who had no desire for future child bearing and who were undergoing laparoscopic myomectomy for symptomatic myomas at 4 institutions. Among them, 41 patients concurrently underwent opportunistic salpingectomy (the opportunistic salpingectomy group) and 65 patients did not undergo salpingectomy at the time of laparoscopic myomectomy (the no-salpingectomy group). The primary and secondary outcome measures were change of ovarian reserve determined by the rate of decline in the anti-Müllerian hormone (AMH) level from before surgery to 3 months post-surgery, and surgical outcomes. Results: Baseline characteristics were similar between groups. There were also no differences in surgical outcomes, such as operative time, operative bleeding, hospital stay, or complications between groups. The decline rate in AMH was 18.6% (interquartile range (IQR) 2.6-46.8%) in the opportunistic salpingectomy group and 10.4% (IQR 2.6-46.8%) in the no-salpingectomy group, with no significant difference between groups (p = 0.593). Conclusion: Opportunistic salpingectomy at the time of laparoscopic myomectomy was not associated with negative effects on ovarian reserve or increased surgical risk.

Factors influencing decision-making around opportunistic salpingectomy: a nationwide survey

“…In addition, the absence of a Dutch guideline was perceived as a suppressive factor for OS. Previous research however, has not found evidence for an increased complication risk, estimated blood loss or duration of hospital stay [81018]. Furthermore, studies on ovarian reserve after OS found no difference in ovarian function after hysterectomy with or without OS [810].…”

“…Several studies investigated this issue, with no difference in ovarian reserve after salpingectomy [789]. Furthermore, there is no evidence for an increased complication rate after OS [68] and literature on surgical time suggests a minor increase of 0–13 minutes, depending on surgical approach [8101112].…”

Salpingectomía oportunista: Patrones de práctica en un grupo de ginecólogos colombianos

“…Respecto a esta última preocupación, tanto la hormona antimulleriana como la hormona foliculoestimulante (FSH), no han demostrado diferencias significativas en los niveles séricos en los meses postoperatorios, con lo cual se discute ampliamente la falla ovárica precoz [35][36][37] .…”

The effect of opportunistic salpingectomy for primary prevention of ovarian cancer on ovarian reserve: a systematic review and meta-analysis

“…Nine were RCTs [33][34][35][36][37][38][39][40][41], and six were cohort studies (three prospective [22,42,43] and three retrospective [44][45][46]). All studies included premenopausal women who underwent OS during abdominal surgery.…”

“…The majority of the studies (12/15) included women who underwent a hysterectomy for benign indication [22,33,34,[36][37][38][39][40][41]43,44,46]. The other three studies concerned women who underwent a caesarean section (n=2) [35,42] or myomectomy (n=1) [45]. All studies except one had a control group who underwent the indicated procedure without OS; one study had a control group that underwent tubal ligation instead of OS as sterilization method.…”