The uncertain fate of ovaries at the time of hysterectomy

M. Giai, R. Ponzone, R. Roagna, N. Biglia, L. Sgro, P. Sismondi

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The aim of this review was to analyse the current opinions on the practice of prophylactic oophorectomy at the time of hysterectomy according to the patient's age. Methods: All publications regarding the role of prophylactic oophorectomy at the time of hysterectomy indexed on CANCER-CD TIM from 1984 to 1994 have been revised. Recent data on the reduction of ovarian cancer incidence and on the risk/benefit assessment of hormonal deprivation compared to hormonal replacement therapy (HRT) following ovarian ablation were also examined. Results: Prophylactic oophorectomy is considered the most effective way of avoiding ovarian cancer and it is widely performed in post-menopausal women. Uncertainty remains for younger women: the use of HRT allows to overcome most part of unfavourable metabolic effects caused by the early hormonal deprivation in those patients who underwent oophorectomy. Furthermore, preserved ovaries do not ensure their regular activity after hysterectomy and sometimes have to be removed due to the 'residual ovary syndrome'. Nevertheless, a good compliance with estrogen therapy is necessary to avoid that the drawbacks of oophorectomy (higher incidence of coronary heart disease and osteoporosis) exceed the benefits (lower incidence of ovarian and breast cancer). Conclusions: There is general agreement on preserving ovaries in women before 40 years and performing prophylactic oophorectomy after 50 years of age at the time of hysterectomy. For patients in the fifth decade of life, risk factors for ovarian cancer and the effectiveness of HRT should be considered; any decision must be taken in accordance with patient's opinion, adequately informed of the potential risks and benefits of therapeutic options.

Original languageEnglish
Pages (from-to)75-84
Number of pages10
JournalItalian Journal of Gynaecology and Obstetrics
Volume6
Issue number4
Publication statusPublished - 1994

Keywords

  • Hysterectomy
  • Oophorectomy
  • Ovarian cancer

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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