IS IT NECESSARY TO PERFORM A PROPHYLACTIC OOPHORECTOMY DURING HYSTERECTOMY

Objective: To evaluate the subsequent pelvic sonographic characteristi cs as well as the clinical outcome following hysterectomy with and wit hout oophorectomy. Study design: A prospective study of sonographic ev aluation of 164 women, aged 29-72 years, with a history of hysterectom y was performed. Ninety-one patients underwent total abdominal hystere ctomy with bilateral salpingo-oophorectomy and 73 women had either hys terectomy (abdominal or vaginal) only or hysterectomy with unilateral salpingo-oophorectomy. Results: The mean time interval between surgery and sonographic evaluation was 4.3 years (range, 1-25 years). Out of the 73 women with left ovaries, 37 (50.7%) were found to have pelvic l esions and four women underwent re-operations following these findings . The histologic finding were cystadenoma, hydrosalpinx with periovari an adhesions and two paraovarian cysts. In comparison, only five of th e 91 women (5.5%) following bilateral salpingo-oophorectomy were found to have pelvic lesions (P <0.0005). None of the women with prophylact ic oophorectomy were operated upon following these findings. Conclusio ns: In comparison to patients after total hysterectomy and bilateral s alpingo-oophorectomy, women with prior hysterectomy and ovarian preser vation are prone to subsequent pelvic lesions. They need to be closely followed with clinical, laboratory and sonographic means, and may und ergo reoperations in order to rule out the possibility of neoplasia. ( C) 1997 Elsevier Science Ireland Ltd.