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Opportunistic salpingectomy during vaginal hysterectomy for a benign pathological condition

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Abstract

Introduction and hypothesis

The objective was to evaluate the surgical feasibility of opportunistic salpingectomy or salpingo-oophorectomy during benign vaginal hysterectomy (HV) and the prevalence of occult tubal lesions.

Methods

In this prospective study from 1 September 2013 to 1 November 2015, the prevalence of bilateral salpingectomy with or without ovariectomy and the prevalence of histopathological and immunohistochemical tubal abnormalities were assessed.

Results

A total 115 patients were included. Bilateral salpingectomy was performed in 85 patients (73.92%; group A) and was technically impossible in 30 patients (26.08%; group B). Older patients (62.9 vs 57.5 years, p = 0.009), menopausal status (83.33% vs 62.35%, p = 0.03) and elevated BMI (27.58 vs 25.05 p = 0.03) were statistically associated with failure of salpingectomy. There was only one case of postoperative hemorrhage in group A. There was no difference with regard to intra- or postoperative complications, blood loss, and operating time between the two groups. Among the 67 fallopian tubes analyzed with a validated histopathological protocol, there were 8 (11.94%) immunohistochemical abnormalities with a “p53 signature.”

Conclusions

With the recent demonstration of a tubal origin of most ovarian cancer, opportunistic salpingectomy could be a theoretically relevant prevention strategy. Bilateral salpingectomy could be performed during benign vaginal hysterectomy by experienced surgeons. The advantages and disadvantages of exclusive salpingectomy during pelvic floor surgery should be discussed with the patients.

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Acknowledgements

We would like to thank our two expert pathologists for the histopathological analyses: Dr Annie Buenerd and Dr Beatrice Nadaud.

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Authors and Affiliations

  1. Department Gynecology, Hôpital Femme Mère Enfant, HFME, Lyon CHU, Lyon, France

    Gery Lamblin, Capucine Meysonnier, Stéphanie Moret, Georges Mellier & Gautier Chene

  2. Department of Pathology, Centre Hospitalier Est, Lyon CHU, Lyon, France

    Béatrice Nadaud

  3. Université Claude Bernard Lyon 1, EMR 3738, 69000, Lyon, France

    Gautier Chene

Authors
  1. Gery Lamblin
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  2. Capucine Meysonnier
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  3. Stéphanie Moret
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  4. Béatrice Nadaud
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  5. Georges Mellier
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  6. Gautier Chene
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Correspondence to Gautier Chene.

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Lamblin, G., Meysonnier, C., Moret, S. et al. Opportunistic salpingectomy during vaginal hysterectomy for a benign pathological condition. Int Urogynecol J 29, 715–721 (2018). https://doi.org/10.1007/s00192-017-3418-0

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  • DOI: https://doi.org/10.1007/s00192-017-3418-0

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