Physicians' Perspectives and Practice Patterns Toward Opportunistic Salpingectomy in High- and Low-Risk Women

Jones, Nathaniel; Schulkin, Jay; Urban, Renata R.; Wright, Jason D.; Burke, William M.; Hou, June Y.; McElwain, Cora; Tergas, Ana I.

doi:10.1080/07357907.2016.1242597

Cited by 22 publications

(27 citation statements)

References 39 publications

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“…Thus, improvement in knowledge of current literature might increase implementation rate. Despite our findings, Jones et al [15] investigated the implementation of OS and found no association between practice patterns and physicians characteristics. This discrepancy could be explained by differences in the subset of analyzed characteristics or study population.…”

Section: Discussioncontrasting

confidence: 99%

“…Currently there is no consensus regarding OS in the Netherlands, resulting in a large variety of practice, probably due to a lack of clear guidelines. According to previous research in other countries, 43%–77% of gynecologists discuss the possibility of an OS [131415]. It is likely that the adoption rate is influenced by several factors, which can be found on different levels, such as the innovation itself (OS), the organization of care, healthcare professionals attitudes towards OS and characteristics of the individual patient [16].…”

Section: Introductionmentioning

confidence: 99%

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Factors influencing decision-making around opportunistic salpingectomy: a nationwide survey

Steenbeek¹,

Lieshout

Aarts³

et al. 2019

J Gynecol Oncol

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ObjectiveTo explore current practice and influencing factors on adoption of the opportunistic salpingectomy (OS), particularly regarding the decision making, to eventually enhance the development and implementation of clear guidelines.MethodsThis nationwide cross-sectional survey study was conducted in all hospitals in the Netherlands. An anonymous online survey was sent to gynecologists with special interest in gynecological oncology, gynecological endoscopy or urogynecology and all Dutch gynecology trainees. The survey mainly focused on current practice regarding OS and identification of influencing factors on the level of innovation, organization, healthcare professional and individual patient.ResultsThe response rate was 348 out of 597 gynecologists (58.3%) and 142 out of 340 trainees (41.8%). Current practice of discussing and performing the OS varied widely, with ovarian cancer (OC) risk reduction as most important supportive factor on innovation level. Supportive factors on the level of organization and healthcare provider were; working in a non-training hospital, knowledge of current literature and extensive work experience (in years and annual number of hysterectomies). On individual patient level, a vaginal approach of hysterectomy, negative family history for OC and the presence of firm adhesions were suppressive factors for the OS.ConclusionIn this study we evaluated the current practice regarding the opportunistic salpingectomy in the Netherlands and identified influencing factors on different levels to raise awareness and attribute to development of a targeted implementation strategy, on both national and international level.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors influencing decision-making around opportunistic salpingectomy: a nationwide survey

Steenbeek¹,

Lieshout

Aarts³

et al. 2019

J Gynecol Oncol

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“…6e9 Nonetheless, many obstetrician/gynecologists have adopted salpingectomy with cesarean delivery. 10 Removal of the fallopian tubes may decrease the risk of ovarian cancer by as much as 70%, which is more than the risk reduction attributed to tubal ligation (26e34%). 11e14 Salpingectomy appears to be safe 15,16 and cost-effective 12,17 with hysterectomy or interval sterilization.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of opportunistic salpingectomy vs tubal ligation at the time of cesarean delivery

Venkatesh

Clark

Stamilio

2019

American Journal of Obstetrics and Gynecology

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Bilateral tubal ligation and bilateral opportunistic salpingectomy with cesarean delivery are both cost-effective strategies for permanent sterilization and ovarian cancer risk reduction. Although salpingectomy and tubal ligation are both reasonable strategies for cesarean patients seeking permanent sterilization and cancer risk reduction, threshold analyses indicate that the risks and benefits of salpingectomy with cesarean delivery need to be better defined before a preferred strategy can be determined.

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“…However, despite this shift towards removal of the Fallopian tubes during ovarian-sparing hysterectomy, a large percentage of women do continue to retain their Fallopian tubes after hysterectomy. It was estimated that 15.8% of ovarian-sparing hysterectomies in 2013 underwent bilateral salpingectomy [9] and a recent study by Jones et al, reported that only 23% of the gynecologists surveyed understood the cancer risk-reduction associated with bilateral salpingectomy [10]. Therefore it is still important for radiologists to be aware of the potential of a dilated fluid-filled Fallopian tube remnant, or hydrosalpinx, as a potential complication of ovarian-sparing hysterectomy [11] since these cystic structures can be mistaken for a cystic adnexal neoplasm.…”

Section: Introductionmentioning

confidence: 99%

Hydrosalpinx in patients with hysterectomy without salpingo-oophorectomy referred for pelvic magnetic resonance imaging

et al. 2019

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Women with ovarian-sparing hysterectomy before 2007 are more likely to have retained Fallopian tube remnants which can become fluid-filled, distended masses, potentially mistaken for a cystic adnexal neoplasm on imaging. Here we assess the prevalence and appearance of hydrosalpinx in women with ovariansparing hysterectomy prior to 2007 referred for pelvic MRI. Methods: A total of 3044 consecutive pelvic MRI exams performed over a two-year period (2003-2004) were selected from our radiology database and retrospectively reviewed. Examinations performed on male patients (N = 858), duplicate examinations on the same patient (N = 675) and examinations performed for MR guided biopsy (N = 1) were excluded from the study. From the remaining female pelvic MRI examinations (N = 1510), patients with hysterectomy without oophorectomy were identified. The frequency of hydrosalpinx in this population was then determined visually by two experienced radiologists and kappa analysis was then performed to assess for interobserver agreement. Results: Of the 3044 pelvic MRI examinations, 1510 were performed on females and 76 (5%) of these women had ovarian-sparing hysterectomy. Of these 76 women, 14 patients (18%) had hydrosalpinx (kappa = 0.8) of which 11 were unilateral and 3 bilateral. A total of 9 of the 14 cases positive for hydrosalpinx in patients with ovarian-sparing hysterectomy were referred to MRI for evaluation of cystic adnexal masses detected on other modalities. Conclusion: Hydrosalpinx should be considered in the differential diagnosis of cystic adnexal lesions in women with prior hysterectomy and retained ovaries.

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Physicians' Perspectives and Practice Patterns Toward Opportunistic Salpingectomy in High- and Low-Risk Women

Abstract: We identified broad support and factors limiting willingness to perform OBS.

Cited by 22 publications

References 39 publications

Factors influencing decision-making around opportunistic salpingectomy: a nationwide survey

Factors influencing decision-making around opportunistic salpingectomy: a nationwide survey

Cost-effectiveness of opportunistic salpingectomy vs tubal ligation at the time of cesarean delivery

Hydrosalpinx in patients with hysterectomy without salpingo-oophorectomy referred for pelvic magnetic resonance imaging

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