Feasibility of Risk Reducing Salpingo-Oophorectomy at the Time of Abdominal Surgery for Correction of Pelvic Organ Prolapse and Urinary Incontinence

Ali Azadi; James A Bradley; Greg J Marchand; Douglas J Lorenz; David Doering; Donald R Ostergard

doi:10.4103/GMIT.GMIT_21_20

Feasibility of Risk Reducing Salpingo-Oophorectomy at the Time of Abdominal Surgery for Correction of Pelvic Organ Prolapse and Urinary Incontinence

Gynecol Minim Invasive Ther. 2021 Jan 30;10(1):10-18. doi: 10.4103/GMIT.GMIT_21_20. eCollection 2021 Jan-Mar.

Authors

Ali Azadi^{1

2}, James A Bradley³, Greg J Marchand⁴, Douglas J Lorenz⁵, David Doering⁶, Donald R Ostergard⁷

Affiliations

¹ Department of Obstetrics/Gynecology, University of Arizona College of Medicine, Phoenix, USA.
² Star Urogynecology, Advanced Pelvic Health Institute for Women, Peoria, USA.
³ Department of Internal Medicine, University of Louisville School of Medicine, Louisville, KY, USA.
⁴ Marchand Institute for Minimally Invasive Surgery, Mesa, AZ, USA.
⁵ Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA.
⁶ Norton Cancer Institute, Norton Healthcare, Louisville, KY, USA.
⁷ Department of Obstetrics and Gynecology, UCLA School of Medicine, Los Angeles, CA, USA.

Abstract

Objective: The objective of this study is to assess the perioperative outcomes when prophylactic bilateral salpingo-oophorectomy (BSO) is performed concomitantly with surgery to repair pelvic organ prolapse (POP) or stress urinary incontinence (SUI).

Materials and methods: This is a retrospective case-control study of patients who underwent abdominal surgery for the correction of POP and/or SUI with or without concomitant BSO at a tertiary care center. The primary outcome measures were postsurgery length of hospitalization, estimated blood loss, and 30-day readmission rate. The secondary outcome measure was detection of ovarian cancer precursor lesions.

Results: We identified 734 patients who had surgery for POP and/or SUI. The control group contained 385 patients, and the BSO group contained 349 patients. There was no difference between the control and BSO groups in the postsurgery length of stay (LOS) (35.2 h vs. 34.1 h; P = 0.49), and all-cause 30-day readmission rate (14.2% vs. 11.6%; P = 0.3085). However, there was decreased blood loss (40.8 ml vs. 67.2 ml, P < 0.0001) in the BSO group compared to the control group. Sub-analysis of primary outcomes in postmenopausal women (age > 55) showed decreased postsurgery LOS (33.4 h vs. 37.4 h; P = 0.0208) and decreased blood loss (35.9 ml vs. 82.7 ml; P < 0.0001) in the BSO group compared to control.

Conclusion: Secondary to the lack of additional complications, we recommend surgeons give more consideration to finding appropriate candidates for a risk reducing BSO at time of abdominal surgery to repair POP or SUI.

Keywords: Ovarian cancer prevention; pelvic organ prolapse; risk reducing oophorectomy; stress urinary incontinence; surgery to reduce the risk of ovarian cancer.