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International Urogynecology Journal

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01-02-2020 | Salpingo-Oophorectomy | Original Article

Adnexectomy at the time of vaginal hysterectomy for pelvic organ prolapse

Authors: Emily A. Slopnick, David D. Sheyn, Graham C. Chapman, Sangeeta T. Mahajan, Sharif El-Nashar, Adonis K. Hijaz

Published in: International Urogynecology Journal | Issue 2/2020

Abstract

Introduction and hypothesis

Preoperative counseling about salpingectomy with pelvic surgery is recommended by the American College of Obstetrics and Gynecology for ovarian cancer risk reduction. Our objective was to determine recent practice patterns and patient factors associated with salpingectomy with vaginal hysterectomy (VH) for pelvic organ prolapse (POP) in the USA. We hypothesize that salpingectomy might have become more common in recent years.

Methods

We queried the 2014–2016 National Surgical Quality Improvement Program database for women with a postoperative diagnosis of POP who underwent VH with any combination of pelvic reconstructive procedures. CPT codes do not differentiate salpingectomy from salpingo-oophorectomy, so subjects were stratified by whether concurrent adnexectomy was performed. Chi-squared and multivariate logistic regression analyses were used to evaluate characteristics associated with adnexectomy. Propensity score matching was utilized when evaluating postoperative complication rates.

Results

Of 5,344 women who underwent VH, 2019 (37.8%) had adnexectomy. Adnexectomy rate increased from 34.4% in 2014 to 46.8% in 2016 (p < 0.001). Adnexectomy rates of fellowship-trained urogynecologists and general gynecologists were similar (36.0% vs 38.8%, p = 0.197). On logistic regression analysis, patients more likely to undergo adnexectomy were < 65 years old (OR 0.844, CI 0.75–0.95, p = 0.004), had BMI <30 (OR 0.76, CI 0.68–0.86, p < 0.001), and were non-smokers (OR 0.78, CI 0.64–0.95, p = 0.016). Mean operative time was 17 min longer with adnexectomy (145 vs 128 min, p < 0.001). There were no differences in postoperative complications or reoperation rates between groups.

Conclusions

Adnexectomy during VH for POP is safe and increasingly utilized by gynecology surgeons in the USA.

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Title: Adnexectomy at the time of vaginal hysterectomy for pelvic organ prolapse
Authors: Emily A. Slopnick
David D. Sheyn
Graham C. Chapman
Sangeeta T. Mahajan
Sharif El-Nashar
Adonis K. Hijaz
Publication date: 01-02-2020
Publisher: Springer International Publishing
Keywords: Salpingo-Oophorectomy
Salpingectomy
Ovarian Cancer
Ovarian Cancer
Hysterectomy
Published in: International Urogynecology Journal / Issue 2/2020
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-019-03967-0

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Adnexectomy at the time of vaginal hysterectomy for pelvic organ prolapse

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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