Obstetrics and gynaecology
Research
Salpingectomy as standard at hysterectomy? A Danish cohort study, 1977–2010
1. Rikke Guldberg1,2,
2. Sonja Wehberg2,
3. Charlotte Wessel Skovlund3,
4. Ole Mogensen1,
5. Øjvind Lidegaard3
Author affiliations
To assess if the risk of first-time salpingectomy was affected by prior hysterectomy with retained fallopian tubes
170 000 randomly selected women born 1947–1963 (10 000/year) were followed from 1977 until the end of 2010. Hysterectomy is the most frequently performed gynaecological surgical intervention among women of reproductive age. In Denmark, there are annually approximately 5000 hysterectomies of benign indication. In 2010, the simultaneous removal of the ovaries and the fallopian tubes was performed in 12% of the hysterectomies.1 After hysterectomy, the blood supply of the ovaries is secured via the infundibulopelvic ligament, and the hormone profile is left unaltered by salpingectomy. No long-term negative effects of salpingectomy at hysterectomy have been reported. The blind-ended remnants of the fallopian tubes may instead give rise to complications such as hydrosalpinx, infection, benign tumours, tube prolapse/torsion, and perhaps induction of ovarian cancer, the most frequent being hydrosalpinx (35.5%). Hysterectomised women have a 7.8% lifetime risk of subsequent surgery of adnexae.
Main outcome measures Effect of hysterectomy with retained fallopian tubes or sterilisation on the risk of salpingectomy at a later date ..
Results Of 9591 hysterectomies, 6456 (67.3%) had both fallopian tubes retained. HRs for salpingectomy after hysterectomy with retained fallopian tubes and sterilisation were 2.13 (95% 1.88 to 2.42) and 2.42 (2.21 to 2.64), as compared with those for non-hysterectomised and non-sterilised women.
Conclusions Women undergoing hysterectomy with retained fallopian tubes or sterilisation have at least a doubled risk of subsequent salpingectomy. Removal of the fallopian tubes at hysterectomy should therefore be recommended.
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