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A prospective study to evaluate oophorectomy at the time of vaginal hysterectomy
A Davies1, H O'Connor, A L Magos
1Minimally Invasive Therapy Unit, Royal Free Hospital, London, UK.
Objective:
To assess the feasibility and safety of vaginal removal of ovaries at the time of vaginal hysterectomy.
Design:
Prospective study.
Setting:
London teaching hospital.
Population:
Between March 1993 and March 1995, 40 women were admitted under the care of one consultant for vaginal hysterectomy and bilateral oophorectomy.
Methods:
The success rate of removing the ovaries vaginally was calculated and the operative time, blood loss, intra- and post-operative complications and patient recovery were analysed and compared with 48 patients who had a vaginal hysterectomy but retained their ovaries during the same time period.
Results:
Thirty-nine (97.5%) of the 40 women due to undergo removal of the ovaries were managed successfully via the vaginal route; one woman required laparoscopic removal of one of her ovaries containing an ovarian cyst which was not diagnosed pre-operatively. A variety of techniques were used for vaginal oophorectomy which included salpingo-oophorectomy, oophorectomy without salpingectomy, and transvaginal endoscopic oophorectomy utilising endoloop sutures or bipolar electrosurgery. Oophorectomy added a mean of 23.4 min (88.3 vs 64.9 min, 95% CI 10.2-36.7, P < 0.001) to the total operating time compared with vaginal hysterectomy alone. No laparotomies were required, and both the complication rate and post-operative inpatient stay were similar for the two groups.
Conclusions:
The need to perform oophorectomy should not be considered a contraindication to vaginal hysterectomy.
