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Bilateral salpingectomy versus bilateral partial salpingectomy during cesarean delivery
Jose R Duncan1,2, Heather L Jones1, Stefanie O Hoffer1
1Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, TN, USA, joserduncan@yahoo.com.
International Journal of Women'S Health
|November 15, 2018
Summary
Bilateral salpingectomy during cesarean delivery slightly increased operative time but did not significantly raise surgical complication risks compared to partial salpingectomy. Further multi-center trials are needed to confirm these findings on sterilization outcomes.
Area of Science:
- Reproductive Medicine
- Surgical Outcomes
- Gynecologic Surgery
Background:
- Cesarean delivery sterilization offers permanent contraception.
- Bilateral salpingectomy is increasingly favored for tubal ligation due to potential ovarian cancer risk reduction.
- Comparing surgical outcomes of bilateral salpingectomy versus partial salpingectomy during cesarean delivery is crucial for clinical decision-making.
Purpose of the Study:
- To compare surgical outcomes between bilateral salpingectomy and partial salpingectomy performed concurrently with cesarean delivery.
- To evaluate operative time, complication rates, and long-term patient satisfaction.
Main Methods:
- Retrospective chart review of 160 women undergoing sterilization during cesarean delivery (July 2015-November 2016).
- Exclusion of sterilization by occlusive methods.
- Primary outcomes: operative time, composite of transfusion, organ injury, readmission, endometritis. Secondary outcomes: menstrual abnormalities, pain, quality of life, regrets.
Main Results:
- Bilateral salpingectomy group (n=41) had a longer median operative time (62 min) versus partial salpingectomy (n=119, 60 min; P=0.03).
- No significant difference in the composite surgical complication rate (19.5% vs 12.6%; P=0.28).
- Menstrual irregularities, quality of life, pelvic pain, and regret rates were similar between groups.
Conclusions:
- Bilateral salpingectomy during cesarean delivery is associated with a modest increase in operative time but not a significantly higher risk of surgical complications.
- Patient-reported outcomes such as menstrual function, pain, and satisfaction did not differ between the two sterilization methods.
- Larger, multi-center trials are warranted to validate these findings and further inform surgical practice.
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