Salpingo‐oophorectomy at the Time of Vaginal Hysterectomy

Alfredo Jijón, G. Willy Davila
In: Gynecologic and Obstetric Surgery · 2016 · pp. 335–337 · doi:10.1002/9781118298565.ch112 · W2466323612
other OA: closed CC0
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This chapter details a case of vaginal hysterectomy with bilateral salpingo-oophorectomy for uterine prolapse, discussing the rationale, techniques, and complications of performing ovarian removal concurrently.

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Abstract

This chapter presents a case where a vaginal hysterectomy (TVH) with bilateral salpingo-oophorectomy (BSO) is planned for a 64-year-old woman with third-degree uterine prolapse. During the preoperative evaluation, the left ovary contained a single 4-cm simple cyst. The purpose of performing a BSO at the time of TVH, especially in postmenopausal women, is reduction of ovarian cancer risk. Poor prognostic factors for the performance of vaginal BSO include advanced age, high BMI, cervical length greater than 7 cm, lower uterine weight, previous pelvic surgery, uterine prolapse, anterior vaginal prolapse, endometriosis, and the presence of pelvic adhesions. Various techniques have been described for performing BSO following a TVH. All techniques require a clear operative field to allow visualization of the pelvic contents and mobilization of the adnexal structures. The chapter also discusses the complications of vaginal BSO such as bleeding from pedicles and ureteral injury.

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endometriosis

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License: CC0 · commercial use OK