Patients’ perceptions toward and the driving factors of decision-making for opportunistic bilateral salpingectomy at the time of cesarean section

Abstract

Objective: Enough data can be found in the literature regarding the protective effect of tubal ligation on gynecological cancers. In addition, a large body of evidence revealed that prophylactic bilateral salpingectomy had no significant negative effect on the ovarian function, quality of life, sexuality, surgery duration, and cost-effectivity. This study was aimed at exploring the underlying factors that motivate women for either opportunistic bilateral salpingectomy (OBS) or tubal ligation, particularly focusing on their preferences, knowledge, and beliefs toward female sterilization, satisfaction from counseling, and body image following the salpingectomy. Materials and Methods: A total of 54 patients who had undergone surgical sterilization with either OBS or tubal ligation were included in this prospective cohort study. The acceptance rate of the OBS at the time of cesarean section among pregnant women seeking surgical sterilization was calculated. The underlying reasons for women’s acceptance or refusal for salpingectomy were assessed by a non-validated data collection tool that had 14 open-ended questions focusing on the women’s preferences, knowledge, beliefs toward female sterilization, satisfaction from counseling, and body image following the salpingectomy. Results: The acceptance rate of OBS at the time of cesarean section among pregnant women and electively among non-pregnant women were 93.5% (n=43/46) and 75% (6/8), respectively. The main driving factors influencing the decision of preferring OBS over tubal ligation were the risk-reducing effect for ovarian cancer and superior pregnancy prevention. Conclusion: The acceptance rate of OBS at the time of cesarean section was found to be very high, and it should therefore be offered at the time of cesarean section to women who desire permanent contraception.

The Comparison of Transvaginal Natural Orifice Transluminal Endoscopic Surgery and Conventional Laparoscopy in Opportunistic Bilateral Salpingectomy for Permanent Female Sterilization

“…5 Since prophylactic BS was shown to have more significant cancer risk reduction than BTL without significantly increasing complication rates and decrease in ovarian function, 1 performing BS for definitive surgical sterilization is emerging, although it is still uncommon. 4,8 In a large population-based retrospective cohort study, although a significant increase was reported in the use of isolated BS for sterilization, there was no difference in surgical approach during the evaluated tme period. 6 The advantages of vaginal surgery are more favorable over other approaches in benign gynecological diseases.. 17,18 However, the limitations of pure vaginal surgery such as insufficient visualization of the surgical field and difficulty in accessing adnexal structures in non-prolapsed uterus restrict the utilization of transvaginal opportunistic BS.…”

“…[1][2][3][4][5][6][7] The fact that opportunistic BS during cesarean section provides a lower risk of ovarian cancer and superior contraception than BTL makes women accept this procedure at rates as high as 93.5% compared to BTL. 8 Opportunistic BS or BTL can be traditionally performed by laparoscopic, abdominal or vaginal routes commonly following any other gynecological procedures. 2 Considering the theoretical benefits of opportunistic BS, The American College of Obstetricians and Gynecologists (Committee opinion No.…”

Association between pelvic inflammatory disease and subsequent salpingectomy on the risk for ovarian cancer

“…Indeed, the incidence of opportunistic salpingectomy in conjunction with hysterectomy appears to have increased substantially the past 10 years [19,20]. Recent studies indicate that women have a high acceptance for salpingectomy, also in combination with non-gynaecological procedures [20,21]. Several societies have issued statements supporting opportunistic salpingectomy at the time of hysterectomy on benign indications [22e24].…”

Salpingectomy for the Primary Prevention of Ovarian Cancer

“…In a 2020 prospective cohort study of 54 women, Yassa and Pulatoğlu 61 found that the acceptance rate of salpingectomy at the time of cesarean delivery was 94% and that the acceptance rate of salpingectomy as an elective procedure among nonpregnant women was 75%. They found that the main factors associated with the preference for salpingectomy vs tubal ligation were ovarian cancer prevention and superior pregnancy prevention.…”