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Thirteen Years of Experience with Opportunistic Bilateral Salpingectomy During TLH in Low-Risk Premenopausal Women

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Abstract

Background

Opportunistic bilateral salpingectomy (OBS), also called as prophylactic salpingectomy or risk-reducing salpingectomy is the concurrent removal of the fallopian tubes in premenopausal women. Though there are some studies comparing the intraoperative complications and effect of salpingectomy on ovarian reserve, limited data are available on long-term follow-up after OBS.

Purpose of the Study

To evaluate the surgical outcome of routine bilateral salpingectomy during total laparoscopic hysterectomy (TLH) in terms of intraoperative and postoperative complications. We also evaluated the incidence and reoperation rate for adnexal pathology after TLH.

Methods

A retrospective study of 1470 patients undergoing total laparoscopic hysterectomy (TLH) with opportunistic bilateral salpingectomy (OBS) over 13 years was carried out at Paul’s Hospital.

Results

The mean age of the subjects was 43.6 ± 4.2 years, mean body mass index was 27 ± 5.4 kg/m2, and median parity was 2 (range 0–7). 43% of women had at least one previous surgery. The most common indication for surgery was fibroid uterus (67%, n = 985). The total complication rate was 4.4% (n = 65). One specimen showed paratubal borderline serous malignancy. The follow-up period ranged from 6 months to 13 years during which 17 (1.1%) women had adnexal pathology, and eight women (1.1%) needed resurgery for it. No ovarian malignancies were reported on follow-up.

Conclusions

OBS is a simple and short surgical step during TLH without increasing morbidity. OBS eliminates the risk of future diseases of tubal origin, and there might be a possible reduction in incidence and reoperation rate for future ovarian pathologies.

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Authors and Affiliations

  1. Centre for Advanced Endoscopy and Infertility Treatment, Paul’s Hospital, Vattekkattu Road, Kaloor, Kochi, Kerala, 682 017, India

    P. G. Paul, Sumina Mannur, Hemant Shintre, George Paul, Gunjan Gulati & Santwan Mehta

Authors
  1. P. G. Paul
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  2. Sumina Mannur
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  3. Hemant Shintre
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  4. George Paul
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  5. Gunjan Gulati
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  6. Santwan Mehta
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Corresponding author

Correspondence to P. G. Paul.

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Conflict of interest

The authors declared that they have no conflict of interest.

Ethics Committee Approval

Written informed consent was obtained from the patients for publication. The retrospective observational nature of the study did not necessitate the local institutional ethics committee approval.

Additional information

Dr. P.G. Paul, M.B.B.S., D.G.O., is a Consultant Gynecologist and Endoscopic Surgeon at Centre for Advanced Endoscopy and Infertility Treatment, Paul’s hospital, Vattekkattu Road, Kaloor, Kochi, Kerala, 682 017, India. Dr. Sumina Mannur, M.B.B.S., M.S., D.N.B., is a Assistant Gynecologist at Centre for Advanced Endoscopy and Infertility Treatment, Paul’s hospital, Vattekkattu Road, Kaloor, Kochi, Kerala, 682 017, India. Dr. Hemant Shintre, M.B.B.S., D.G.O., D.N.B., is a Assistant Gynecologist at Centre for Advanced Endoscopy and Infertility Treatment, Paul’s hospital, Vattekkattu Road, Kaloor, Kochi, Kerala, 682 017, India. Dr. George Paul, M.B.B.S., M.S., is a Assistant Gynecologist at Centre for Advanced Endoscopy and Infertility Treatment, Paul’s hospital, Vattekkattu Road, Kaloor, Kochi, Kerala, 682 017, India. Dr. Gunjan Gulati, M.B.B.S., M.S., is a Assistant Gynecologist at Centre for Advanced Endoscopy and Infertility Treatment, Paul’s hospital, Vattekkattu Road, Kaloor, Kochi, Kerala, 682 017, India. Dr. Santwan Mehta, M.B.B.S., M.S., is a Assistant Gynecologist at Centre for Advanced Endoscopy and Infertility Treatment, Paul’s hospital, Vattekkattu Road, Kaloor, Kochi, Kerala, 682 017, India.

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Paul, P.G., Mannur, S., Shintre, H. et al. Thirteen Years of Experience with Opportunistic Bilateral Salpingectomy During TLH in Low-Risk Premenopausal Women. J Obstet Gynecol India 68, 314–319 (2018). https://doi.org/10.1007/s13224-018-1131-7

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  • DOI: https://doi.org/10.1007/s13224-018-1131-7

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