Introduction/Background The opportunistic salpingectomy (OS) during hysterectomy for prevention of ovarian cancer is under discussion for the general population. The effect on ovarian cancer risk, surgery-related adverse events and ovarian reserve have not been fully elucidated. We aim to evaluate benefits and potential harms of OS during hysterectomy for benign gynaecological complaints.
Methodology We searched the Cochrane register of controlled trials, CENTRAL, MEDLINE and Embase from inception to January 2019. Regarding ovarian cancer incidence, both non-randomised trials (NRTs) and randomised controlled trials (RCTs) were eligible. For surgery-related adverse events and ovarian reserve, only RCTs were included. Two review authors independently screened and selected studies, extracted data and assessed risk of bias.
Results We screened 3748 trials and identified zero NRTs and seven RCTs with 347 women in total. Five trials were at high risk of bias in at least one domain. No studies were available on ovarian cancer incidence. We found no statistically significant difference in intra-operative or post-operative adverse events or in ovarian reserve, based on post-operative AMH concentration after hysterectomy with or without OS (table 1). Duration of follow-up was limited to a maximum of 6 months.
Conclusion There were no studies available on the effect of OS during hysterectomy on ovarian cancer incidence that met our inclusion criteria. We found no significant difference in surgery-related adverse event or ovarian reserve after hysterectomy with or without OS. To conclude; the OS seems to be a safe procedure both surgically and with regards to ovarian reserve, however the effect on ovarian cancer risk when performed during hysterectomy is not proven. Especially in young women, for whom an effect on ovarian reserve would be more clinically relevant, long term effects should be investigated.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.