Transvaginal Mobilization and Removal of Ovaries and Fallopian Tubes After Vaginal Hysterectomy

Ballard, Lester A.; Walters, Mark D.

doi:10.1016/0029-7844(95)00346-0

Cited by 39 publications

(20 citation statements)

References 6 publications

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“…In this case, both the use of a novel clamp and a nonconventional (vaginal) route to perform BSO at the time of hysterectomy were being assessed. Previous studies have reported either vaginal oophorectomy alone or vaginal BSO using conventional clamps, but these procedures have usually necessitated taking several small bites of the round ligament and mesovarium/infundibulopelvic ligament [1,4,7,10]. In one study, adnexal surgery prolonged the overall vaginal operation by an average of 23 min [4].…”

Section: Discussionmentioning

confidence: 95%

“…This method, however, has drawbacks similar to operative laparoscopy. There are also reports of oophorectomy/salpingooophorectomy being performed either unilaterally or bilaterally using conventional clamps [1,4,7,10]. However, in most of these cases, the adnexal part of the operation needed to be done in stages-i.e., by dividing the round ligament separately before taking small bites of the mesovarium or infundibulopelvic ligament.…”

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confidence: 93%

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Abdominal, laparoscopic, and vaginal hysterectomy with bilateral salpingo-oophorectomy

Nwosu

Gupta

1999

Surg Endosc

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Section: Discussionmentioning

confidence: 95%

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confidence: 93%

Abdominal, laparoscopic, and vaginal hysterectomy with bilateral salpingo-oophorectomy

Nwosu

Gupta

1999

Surg Endosc

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“…This is consistent with the study of Ballard LA et al and Walters MD et al In this study Table 9, 10 and Figure 1 shows most common indication Fibroid uterus for TAH is and its correlation with age group, parity and HPR. 8,9 Table 10 shows that women undergone TAH for Fibroid uterus were most commonly in parity 4 [n=160 (46.0%)].…”

Section: Discussionmentioning

confidence: 99%

Retrospective analytical study of total abdominal hyeterectomy for benign gynaecological conditions

Pathak

Singh

Tripathi

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Hysterectomy, which is one of the most common surgeries performed on women, dates back to ancient time. This retrospective study was done to determine a baseline data on various indications for total abdominal hysterectomy for benign gynaecological conditions, most common presenting symptoms, and socio-economic status and their histopathology correlation.Methods: This retrospective study was performed in the department of Obstetrics and gynaecology, in collaboration with Department of Pathology, Gandhi Medical College, Bhopal. Baseline data were collected from inpatient files and histopathology reports to determine the indication for surgery, pattern of gynaecological diseases, and distribution with respect to age, parity, rural, urban, socio-economic status and final histopathology correlation. Histopathology reports were collected from Department of Pathology.Results: Majority of women undergone TAH for benign gynaecological diseases were in age group of 40-49 years [n=341 (48.99% cases)], multi para and from urban areas (57.26%). most common indication for TAH is fibroid uterus [n=347 (49.85%)]. The most common mode of presentation is excessive prolonged frequent bleeding per vagina (58.14%). Most common histopathology reports of TAH were leiomyoma with chronic cervicitis {n=347 (49.78%)}.Conclusions: Majority of women undergoing for TAH for benign gynaecological conditions have great satisfaction as they got relieved from their complaints and very minimum post-operative complications, but their long term outcome are still debatable.

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“…Two thirds or more of vaginal hysterectomies with prophylactic salpingo-oophorectomy are completed with minimal or no increases in operative time and surgical morbidity. 12 It isunclear what proportion of patients can have prophylactic salpingectomy successfully performed at the time of vaginal hysterectomy. We suspect surgeons may be discouraged from vaginal salpingectomy at the time of vaginal hysterectomy with the thought it is technically challenging and may increase operative time and potentially blood loss.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of prophylactic salpingectomy during vaginal hysterectomy

Antosh

High

Brown

et al. 2017

American Journal of Obstetrics and Gynecology

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BACKGROUND: The American Congress of Obstetricians and Gynecologists recommends that “the surgeon and patient discuss the potential benefits of the removal of the fallopian tubes during a hysterectomy in women at population risk of ovarian cancer who are not having an oophorectomy,” resulting in an increasing rate of salpingectomy at the time of hysterectomy. Rates of salpingectomy are highest for laparoscopic and lowest for vaginal hysterectomy. OBJECTIVE: The primary objective of this study was to determine the feasibility of bilateral salpingectomy at the time of vaginal hysterectomy. Secondary objectives included identification of factors associated with unsuccessful salpingectomy and assessment of its impact on operating time, blood loss, surgical complications, and menopausal symptoms. STUDY DESIGN: This was a multicenter, prospective study of patients undergoing planned vaginal hysterectomy with bilateral salpingectomy. Baseline medical data along with operative findings, operative time, and blood loss for salpingectomy were recorded. Uterine weight and pathology reports for all fallopian tubes were reviewed. Patients completed the Menopause Rating Scale at baseline and at postoperative follow-up. Descriptive analyses were performed to characterize the sample and compare those with successful and unsuccessful completion of planned salpingectomy using Student t test, and χ2 test when appropriate. Questionnaire scores were compared using paired t tests. RESULTS: Among 77 patients offered enrollment, 74 consented (96%), and complete data were available regarding primary outcome for 69 (93%). Mean age was 51 years. Median body mass index was 29.1 kg/m2; median vaginal parity was 2, and 41% were postmenopausal. The indications for hysterectomy included prolapse (78%), heavy menstrual bleeding (20%), and fibroids (11%). When excluding conversions to alternate routes, vaginal salpingectomy was successfully performed in 52/64 (81%) women. Mean operating time for bilateral salpingectomy was 11 (±5.6) minutes, with additional estimated blood loss of 6 (±16.3) mL. There were 8 surgical complications: 3 hemorrhages >500 mL and 5 conversions to alternate routes of surgery, but none of these were due to the salpingectomy. Mean uterine weight was 102 g and there were no malignancies on fallopian tube pathology. Among the 17 patients in whom planned bilateral salpingectomy was not completed, unilateral salpingectomy was performed in 7 patients. Reasons for noncompletion included: tubes high in the pelvis (8), conversion to alternate route for pathology (4), bowel or sidewall adhesions (3), tubes absent (1), and ovarian adhesions (1). Prior adnexal surgery (odds ratio, 2.9; 95% confidence interval, 1.5–5.5; P – .006) and uterine fibroids (odds ratio, 5.8; 95% confidence interval, 1.5–22.5; P = .02) were the only significant factors associated with unsuccessful bilateral salpingectomy. Mean menopause scores improved after successful salpingectomy (12.7 vs 8.6; P < .001). CONCLUSION: Vaginal salpingectomy is feasib...

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Transvaginal Mobilization and Removal of Ovaries and Fallopian Tubes After Vaginal Hysterectomy

Abstract: Transvaginal removal of ovaries and tubes can be achieved in about two-thirds of women undergoing vaginal hysterectomy with minimal or no increases in operating time and surgical morbidity.

Cited by 39 publications

References 6 publications

Abdominal, laparoscopic, and vaginal hysterectomy with bilateral salpingo-oophorectomy

Abdominal, laparoscopic, and vaginal hysterectomy with bilateral salpingo-oophorectomy

Retrospective analytical study of total abdominal hyeterectomy for benign gynaecological conditions

Feasibility of prophylactic salpingectomy during vaginal hysterectomy

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