Utilization and Outcomes of Ovarian Conservation at Hysterectomy for Benign Gynecologic Indications [15Q]

INTRODUCTION: The long-term benefits of ovarian conservation (OC) in young women have been well-established, however short-term outcomes remain relatively understudied. We examined utilization and outcomes of OC at the time of hysterectomy for benign gynecologic disease. METHODS: A population-based retrospective analysis of the Nationwide Inpatient Sample between 2001-2015 was performed. Hospital discharge records for women <50 years undergoing hysterectomy for benign gynecologic disease, without ovarian pathology or malignancy, were extracted and weighted. Women were grouped as elective oophorectomy versus OC. Propensity score matching was performed, and length of hospitalization, total charges, and perioperative complications were compared. RESULTS: There were 1,432,046 women who underwent hysterectomy for benign gynecologic disease during the study period, and 1,084,703 (75.7%) women had OC. OC rates varied between 71.5% and 79.9% during the study period (P<0.05). OC was associated with younger age, Black/Hispanic race, non-obese habitus, fewer comorbidities, higher household income, Medicaid insurance, residence in the Northeast, urban-teaching hospital status, and minimally-invasive hysterectomy approach (all, P2 days (27.8% vs. 30.9%, relative risk reduction 10.1%, P<0.001) and median total charges ($17,383 vs. $18,419, net difference -$1,036, P<0.001) were significantly lower for women who had OC compared to oophorectomy. Perioperative complication rates were clinically similar (9.0% vs. 9.2%, P=0.004). Similar findings were observed among women <45 and <40 years of age (all, P<0.05). CONCLUSION: Our study suggests that OC is associated with modestly decreased length of hospitalization and total charges in young women undergoing hysterectomy for benign gynecologic indications.