Hysterectomy with bilateral salpingo-oophorectomy: a survey of gynecological practice

Abstract

Background: Oophorectomy at the time of hysterectomy can be carried out by open and minimally invasive methods. The objective of this survey was to determine the current operative practice concerning oophorectomy at hysterectomy for benign gynecological disease in the UK, and to establish practitioners' views regarding the desirability of a randomized controlled clinical trial to compare various operative techniques for this procedure.

Setting: Gynecologists associated with the British Society of Gynecological Endoscopy.

Methods: A self-administered structured questionnaire was posted to 323 UK gynecologists to enquire about their surgical practice in performing oophorectomy at hysterectomy and their willingness to participate in a randomized trial.

Results: The postal questionnaire was returned by 147 (46% response rate). For performing oophorectomy at hysterectomy, 84 (57%) routinely used laparotomy only. However, 67 (46%) in total were competent in all surgical methods i.e. laparotomy, vaginal and laparoscopical. Of these, 38 (57%) were willing to enter patients into a proposed clinical trial comparing vaginal and laparoscopically assisted oophorectomy at hysterectomy.

Conclusion: The current surgical approach to performing oophorectomy at hysterectomy varies widely. This suggests that opinion regarding the relative roles of abdominal, vaginal and laparoscopic methods is divided. Hence, a rigorous randomized trial comparing the efficacy and safety of these methods is practicable and urgently needed.