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Sunday, July 14, 2013

What is my risk of re-operation if I elect to preserve my ovaries during hysterectomy?



About 500,000 hysterectomies are performed annually in the US.   Many of these surgeries are done for benign (non cancer) reason such as bleeding, fibroid, etc.    Many of these patients, especially if they are young, are often offered to remove their uterus but preserve their ovaries.   They often ask what is the risk of needing surgery in the future because of some problems with their ovaries.
 
Casiano and her team published a study to answer such question. Using Rochester Epidemiology Project resources,  they compared the risk of oophorectomy (removal of ovaries), among 4,931 women, who underwent ovary-sparing hysterectomy for benign indications (case group)  with 4,931 age-matched women who did not undergo hysterectomy (referent group).  With 30 years follow up, 9.2% of women of elected to preserve their ovaries required another surgery to remove the ovaries.   This only 1.9 percentage points higher than the incidence of oophorectomy in referent women with intact reproductive organs.

The conclusion of the study is try to preserve your ovaries during hysterectomy if you are pre-menopausal and being operated for non-cancer diagnosis.  However, as always, your case may be unique and do discuss it with your surgeon.

Reference:
Casiano ER, Trabuco EC, Bharucha AE, Weaver AL, Schleck CD, Melton LJ 3rd, Gebhart JB. Risk of oophorectomy after hysterectomy. Obstet Gynecol. 2013 May;121(5):1069-74

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