When is Tubectomy and When Ovarectomy/Adnexectomy Indicated at Necessary Hysterectomies Beyond the Reproductive Age?

With many indicated hysterectomies at the age beyond 45 years we have to decide on concomitant adnexectomies, tubectomies, or ovarectomies. As oophorectomy is associated with decreased long-term health outcomes ovarian conservation should be considered in many women having pelvic surgery. Adnexectomy or salpingo-oophorectomy may be the procedure of choice for “ovarian/tubal” cancer prophylaxis or after numerous previous surgical interventions on the adnexas. Oophorectomy is indicated for women with an adnexal mass that is suspicious for malignancy or for a mass that increases in size or complexity when monitored with serial sonography. Adnexal torsion can usually be treated with de-torsion rather than adnexectomy. Oophorectomy decreases the likelihood of repeat surgery in women with severe, symptomatic endometriosis, but ovarian conservation should be considered in those women who are younger than age 40, since conservation avoids early surgical menopause. Tubectomy or salpingectomy with hysterectomies, however, is considered today as good standard care at hysterectomies for adnexal cancer prevention. Similar content being viewed by others

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