Geography and physician caseload are key factors in oophorectomy rates, according to Yale study

November 28, 1999

Whether or not a woman's ovaries are removed during hysterectomy depends partly on where she lives and her surgeon's experience, according to a Yale School of Medicine study.

Removal of healthy ovaries-oophorectomy-is believed to be the most effective means of preventing ovarian cancer, the fourth most common cause of death in American women. The American College of Obstetrics and Gynecology recommends that oophorectomy may be considered when postmenopausal patients undergo hysterectomy, and that each patient should make their own decision about whether to have an oophorectomy after weighing the risks and benefits.

Published in the December issue of Obstetrics & Gynecology, the study raises concerns that women are not being presented with the information needed to make the decision to remove or keep their ovaries.

"Our study suggests that physician practice style, rather than patient preferences, might be guiding the decision about oophorectomies," said Cary P. Gross, M.D., assistant professor of internal and general medicine at Yale.

The study looked at postmenopausal women who had hysterectomies-removal of the uterus-in the state of Maryland. Whether the hysterectomies included oophorectomy depended on where in the state the women lived and whether they received a vaginal or abdominal hysterectomy. Additionally, women who were given a vaginal hysterectomy by a surgeon who frequently performed the procedure, were significantly more likely to have an oophorectomy.

"The final decision should lie in the hands of the patient," said Gross. "Physicians have an obligation to explain the risks and benefits to their patients before oophorectomy is performed."

The researchers used a comprehensive database to identify all postmenopausal women who had undergone a hysterectomy in Maryland during 1994 - 96. They found that 62 percent of these women had an oophorectomy. However, significant variation in the use of oophorectomy suggested that physicians, rather than patients, may be making the decision about who receives an oophorectomy.

"Women who had a hysterectomy in some areas of the state were significantly more likely to have had an oophorectomy than women in other areas," said Gross. "The way the hysterectomy was performed was strongly associated with the likelihood of having an oophorectomy. While 89 percent of abdominal hysterectomies were accompanied by an oophorectomy, only 27 percent of hysterectomies performed vaginally had an oophorectomy."

Surgeons who performed a high number of vaginal hysterectomies-a more technically difficult procedure-were 72 percent more likely to perform an oophorectomy than their less experienced counterparts, implying that their additional expertise translated into a higher likelihood of performing an oophorectomy.

The study was funded by the Robert Wood Johnson Clinical Scholars Program. In addition to Gross at Yale, the study's investigators included Wanda Nicholson, M.D., and Neil Powe, M.D. from Johns Hopkins Medical Institutions.
-end-


Yale University

Related Hysterectomy Articles from Brightsurf:

Comparing survival after minimally invasive hysterectomy or open surgery for early-stage cervical cancer
This study combined the results of 15 observational studies with 9,500 patients who underwent radical hysterectomy for early-stage cervical cancer to compare the risk of cancer recurrence and death associated with receiving minimally invasive versus open radical hysterectomy.

New study confirms superiority of open surgery for early-stage cervical cancer
A study led by researchers at Columbia University Irving Medical Center confirms that minimally invasive surgery for early-stage cervical cancer is linked to higher rates of recurrence and death compared with open surgery.

Simple conversations can reduce opioid prescriptions after hysterectomy
Women who undergo a hysterectomy are often prescribed at least twice as many opioids as they use - but there may be a simple way to change that.

Hysterectomy and mesh support may have similar outcomes in repairing vaginal prolapse
Two surgical procedures used to repair vaginal prolapse -- hysterectomy and employing mesh support that preserves the uterus -- have comparable clinical outcomes after three years, according to new data from researchers at University of California San Diego School of Medicine.

Comparing effectiveness of 2 surgical methods for uterine prolapse
Uterine prolapse happens when weakened muscles and ligaments no longer provide enough support for the uterus, which then protrudes into or out of the vagina.

Study finds women at greater risk of depression, anxiety after hysterectomy
Hysterectomy is associated with an increased risk of long-term mental health issues, especially depression and anxiety, according to a cohort study by Mayo Clinic researchers involving nearly 2,100 women.

Study shows incidence rates of aggressive subtypes of uterine cancer rising
New findings from a study by researchers at the National Cancer Institute (NCI), part of the National Institutes of Health, show that US incidence rates for aggressive subtypes of uterine cancer rose rapidly among women ages 30 to 79 from 2000 to 2015.

Hysterectomy may be linked to brain function
Hysterectomy can impair some types of memory in the short term following the surgery, according to a rat study published in the Endocrine Society's journal Endocrinology.

For early cervical cancer, open hysterectomy is safer than minimally invasive surgery
A new study found that the risk of death was significantly higher for women with early cervical cancer if they had a minimally invasive hysterectomy instead of open surgery.

Minimally invasive surgery associated with worse survival for women with cervical cancer compared to open hysterectomy
When comparing standard-of-care surgical options for women with early-stage cervical cancer, two studies led by researchers at The University of Texas MD Anderson Cancer Center discovered that minimally invasive radical hysterectomy is associated with higher recurrence rates and worse overall survival (OS), compared to abdominal radical hysterectomy.

Read More: Hysterectomy News and Hysterectomy Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.