Risks and Benefits of Opportunistic Salpingectomy During Vaginal Hysterectomy

Abstract BackgroundHysterectomy is a common procedure worldwide and removing healthy fallopian tubes at the time of hysterectomy (opportunistic salpingectomy) to possibly prevent ovarian cancer is increasing in frequency, but still controversial. The experiences and perceptions of women, eligible for the procedure, have not been previously investigated.This study aims to, among women waiting to undergo hysterectomy, explore i) experiences and perceptions of self and healthcare in relation to their elective surgery, ii) perceptions of risks and benefits of hysterectomy, including opportunistic salpingectomy.MethodsA qualitative study, with focus group discussions including women < 55 years, planned for hysterectomy with ovarian preservation, was performed. Participants were recruited through purposive sampling from six gynecological departments in different parts of Sweden, including both country and university hospitals. Focus group discussions were conducted using a semi-structured interview guide, digitally recorded, transcribed verbatim and analysed by qualitative manifest and latent content analysis.ResultsTwenty-one Swedish-speaking women participated. They were 40-53 years of age, reported varying educational levels, countries of birth and indications for hysterectomy. Analysis rendered a theme “Bridging different realities” over four categories: “Being a woman today”, “Experiencing and managing body failure”, “Navigating the healthcare system” and “Processing continuously until surgery”, including 17 subcategories. The participants displayed varying attitudes towards the significance of their uterus in being a woman. A vague understanding of their body was described, leading to fear related to the reasons for surgery as well as surgery itself. Participants described difficulties understanding and recalling information but also stated that insufficient information was provided. Perceptions of the risks and benefits of opportunistic salpingectomy varied. Involvement in decisions regarding the hysterectomy and potential opportunistic salpingectomy was perceived to be dependent on the counselling gynecologist.ConclusionsThe theme Bridging different realities captures the complexity of women deciding on removal of their uterus, and possibly fallopian tubes. It also describes the women’s interactions with healthcare and perceived difference between the health professionals and the women’s perception of the situation, as viewed by the women. Bridging the different realities faced by patients is required to enable shared decision-making, through sufficient support from healthcare.

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Bridging different realities - a qualitative study on patients experiences of preoperative care for benign hysterectomy and opportunistic salpingectomy in Sweden

10.21203/rs.3.rs-33793/v2 ◽

2020 ◽

Author(s):

Elin Collins ◽

Maria Lindqvist ◽

Ingrid Mogren ◽

Annika Idahl

Keyword(s):

Focus Group ◽

Qualitative Study ◽

Elective Surgery ◽

Structured Interview ◽

Fallopian Tubes ◽

Focus Group Discussions ◽

Group Discussions ◽

Common Procedure ◽

Risks And Benefits ◽

Opportunistic Salpingectomy

Abstract Background Hysterectomy is a common procedure worldwide and removing healthy fallopian tubes at the time of hysterectomy (opportunistic salpingectomy) to possibly prevent ovarian cancer is increasing in frequency, but still controversial. The experiences and perceptions of women, eligible for the procedure, have not been previously investigated.This study aims to, among women waiting to undergo hysterectomy, explore i) experiences and perceptions of self and healthcare in relation to their elective surgery, ii) perceptions of risks and benefits of hysterectomy, including opportunistic salpingectomy.Methods A qualitative study, with focus group discussions including women < 55 years, planned for hysterectomy with ovarian preservation, was performed. Participants were recruited through purposive sampling from six gynecological departments in different parts of Sweden, including both country and university hospitals. Focus group discussions were conducted using a semi-structured interview guide, digitally recorded, transcribed verbatim and analysed by qualitative manifest and latent content analysis. Results Twenty-one Swedish-speaking women participated. They were 40-53 years of age, reported varying educational levels, countries of birth and indications for hysterectomy. Analysis rendered a theme “Bridging different realities” over four categories: “Being a woman today”, “Experiencing and managing body failure”, “Navigating the healthcare system” and “Processing continuously until surgery”, including 17 subcategories. The participants displayed varying attitudes towards the significance of their uterus in being a woman. A vague understanding of their body was described, leading to fear related to the reasons for surgery as well as surgery itself. Participants described difficulties understanding and recalling information but also stated that insufficient information was provided. Perceptions of the risks and benefits of opportunistic salpingectomy varied. Involvement in decisions regarding the hysterectomy and potential opportunistic salpingectomy was perceived to be dependent on the counselling gynecologist. Conclusions The theme Bridging different realities captures the complexity of women deciding on removal of their uterus, and possibly fallopian tubes. It also describes the women’s interactions with healthcare and perceived difference between the health professionals and the women’s perception of the situation, as viewed by the women. Bridging the different realities faced by patients is required to enable shared decision-making, through sufficient support from healthcare.

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Experience with opportunistic salpingectomy during vaginal hysterectomy for uterine prolapsus

Aegean Journal of Obstetrics and Gynecology ◽

10.46328/aejog.v1i1.10 ◽

2019 ◽

Vol 1 (1) ◽

pp. 1-4

Author(s):

Emrah Töz ◽

Aykut Özcan

Keyword(s):

Clinical Practice ◽

Vaginal Hysterectomy ◽

Gynecologic Oncology ◽

Operating Time ◽

Intraoperative Complication ◽

Estimated Blood Loss ◽

Practice Recommendation ◽

Group 2 ◽

Opportunistic Salpingectomy ◽

Group 1

Objective: The aim of this study was to evaluate the trend in uptake of salpingectomy at the time of vaginal hysterectomy after the Clinical Practice Statement of Society for Gynecologic Oncology and to assess the risk of operative/postoperative complications associated with salpingectomy during vaginal hysterectomy. Material and Methods: Patients who underwent vaginal hysterectomy or vaginal hysterectomy with salpingectomy for uterine prolapsus between January 2010 and January 2018 were analysed. We divided the patients into two groups to see the change in the rate of opportunistic salpingectomy after a systemwide practice recommendation was issued. Group 1 consist of patients who were operated between 2010-2014, before recommendation of the Society of Gynecologic Oncology that favour salpingectomy and Group 2 consist of patients operated after that. Results: From January 2010 to January 2018, a total of 1224 vaginal hysterectomies were performed. A total of 808 patients under 60 years old were included in the study. There was no difference in operating time, the median estimated blood loss, intraoperative complication and postoperative complication by the performance of salpingectomy (P>0.05). When we examine the changes in the rate of salpingectomy year by year, from 2014, the salpingectomy rates increased, being 4 % in 2013, 7 % in 2015, and 8 % in 2017 onward. Conclusion: We report an increase in the rate of salpingectomy during vaginal hysterectomies from 3 % to 7.2 % after the recommendation of the Society of Gynecologic Oncology that favour salpingectomy but this increase is not as great as the increase during laparoscopic or abdominal hysterectomies.

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Bridging different realities - a qualitative study on patients’ experiences of preoperative care for benign hysterectomy and opportunistic salpingectomy in Sweden

BMC Women s Health ◽

10.1186/s12905-020-01065-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Elin Collins ◽

Maria Lindqvist ◽

Ingrid Mogren ◽

Annika Idahl

Keyword(s):

Focus Group ◽

Qualitative Study ◽

Elective Surgery ◽

Structured Interview ◽

Fallopian Tubes ◽

Focus Group Discussions ◽

Group Discussions ◽

Common Procedure ◽

Risks And Benefits ◽

Opportunistic Salpingectomy

Abstract Background Hysterectomy is a common procedure worldwide and removing healthy fallopian tubes at the time of hysterectomy (opportunistic salpingectomy) to possibly prevent ovarian cancer is increasing in frequency, but still controversial. The experiences and perceptions of women, eligible for the procedure, have not been previously investigated. This study aims to, among women waiting to undergo hysterectomy, explore i) experiences and perceptions of self and healthcare in relation to their elective surgery, ii) perceptions of risks and benefits of hysterectomy, including opportunistic salpingectomy. Methods A qualitative study, with focus group discussions including women < 55 years, planned for hysterectomy with ovarian preservation, was performed. Participants were recruited through purposive sampling from six gynecological departments in different parts of Sweden, including both country and university hospitals. Focus group discussions were conducted using a semi-structured interview guide, digitally recorded, transcribed verbatim and analysed by qualitative manifest and latent content analysis. Results Twenty-one Swedish-speaking women participated. They were 40–53 years of age, reported varying educational levels, countries of birth and indications for hysterectomy. Analysis rendered a theme “Bridging different realities” over four categories: “Being a woman today”, “Experiencing and managing body failure”, “Navigating the healthcare system” and “Processing continuously until surgery”, including 17 subcategories. The participants displayed varying attitudes towards the significance of their uterus in being a woman. A vague understanding of their body was described, leading to fear related to the reasons for surgery as well as surgery itself. Participants described difficulties understanding and recalling information but also stated that insufficient information was provided. Perceptions of the risks and benefits of opportunistic salpingectomy varied. Involvement in decisions regarding the hysterectomy and potential opportunistic salpingectomy was perceived to be dependent on the counselling gynecologist. Conclusions The theme Bridging different realities captures the complexity of women deciding on removal of their uterus, and possibly fallopian tubes. It also describes the women’s interactions with healthcare and perceived difference between the health professionals and the women’s perception of the situation, as viewed by the women. Bridging the different realities faced by patients is required to enable shared decision-making, through sufficient support from healthcare.

Download Full-text