Bilateral Salpingo-Oophorectomy at the time of hysterectomy for benign conditions: Patterns and factors influencing procedure rate


George Mallat, Dr Maria Quartararo, Jonathan Larach

Background

In women undergoing hysterectomy for benign gynaecological conditions, prophylactic bilateral salpingectomy (BS) and bilateral salpingo-oophorectomy (BS) may significantly reduce future ovarian cancer risk. In light of this evidence, rates of opportunistic bilateral salpingo-oophorectomy (BSO) have been decreasing internationally over the last 10 years, due to concerns surrounding the adverse effects of premature surgical menopause.  

Aims

To examine the pattern of adnexal procedures in addition to hysterectomy for benign conditions and to explore factors which may have influenced this pattern.  

Materials and methods

Using NSW Health APDC data between the financial years 2000/01 – 2012/13, annual rates of bilateral salpingo-oophorectomy were calculated. Chi-square analysis was performed to explore associations. Binary logistic regression analysis was performed to identify factors that influence rates of BSO

Results

There was an overall small increasing trend in rates of BSO over the study period. The odds of undergoing BSO were independently (p<0.05) increased by rural hospital location (compared with metropolitan hospitals), acute or district private hospital type (compared with principal referral and public hospitals), abdominal route of hysterectomy (compared with laparoscopic and vaginal route), a principle diagnosis of endometriosis (compared with leiomyoma and pelvic organ prolapse), and older age (compared with women <25 years old).