Determinants of the decision to perform prophylactic oophorectomy in association with a hysterectomy for a benign condition

Background

The decision to perform an elective bilateral salpingo-oophorectomy (BSO) at the time of a hysterectomy for a benign condition is complex.

Aim

To assess the determinants of the decision to proceed to a prophylactic BSO during a hysterectomy for a benign condition.

Materials and methods

We collected demographic and clinical data, including age, menopausal status and risk of ovarian cancer. Using a regression model we analysed the decision perform a prophylactic BSO in women successively admitted for a hysterectomy for a benign condition, in relation to the collected demographic and clinical data.

Results

Data were collected for 43 women, aged between 37 and 65 years (mean age 48.6 years, SD 6.9), on the day before their hysterectomy. Thirty-six (84%) had a total hysterectomy and 7 (16%) a subtotal hysterectomy; 40 (93%) had a laparoscopic procedure. Prophylactic BSO was significantly associated with age: none of the women aged under 40 years had the procedure, compared with 8% of those aged 41–45 years, 29% of those aged 46–50 years and 83% of those aged 51 years or more (χ² = 23; P < 0.001). Of the postmenopausal women, 67% had a prophylactic BSO, compared with 24% of the premenopausal women (χ² = 6; P < 0.047). In this small series of patients no relationship was found between the decision to perform a BSO and the risk of ovarian cancer. Age was the only significant variable in the regression model (pseudo R² Nagelkerke = 0.6, P < 0.05).

Conclusion

The physician's recommendation to perform an elective BSO at the time of a hysterectomy for a benign condition is strongly influenced by the patients’ age.