Hysterectomy with bilateral salpingo-oophorectomy: A survey of gynecological practice

Background. Oophorectomy at the time of hysterectomy can be carried out by open and minimally invasive methods. The objective of this survey was to de termine the current operative practice concerning oophorectomy at hysterect omy for benign gynecological disease in the UK, and to establish practition ers' views regarding the desirability of a randomized controlled clinical t rial to compare various operative techniques for this procedure. Setting. G ynecologists associated with the British Society of Gynecological Endoscopy . Methods. A self-administered structured questionnaire was posted to 323 UK gynecologists to enquire about their surgical practice in performing oophor ectomy at hysterectomy and their willingness to participate in a randomized trial. Results. The postal questionnaire was returned by 147 (46% response rate). For performing oophorectomy at hysterectomy, 84 (57%) routinely used laparo tomy only. However, 67 (46%) in total were competent in all surgical method s i.e. laparotomy, vaginal and laparoscopical. Of these, 38 (57%) were will ing to enter patients into a proposed clinical trial comparing vaginal and laparoscopically assisted oophorectomy at hysterectomy. Conclusion. The current surgical approach to performing oophorectomy at hys terectomy varies widely. This suggests that opinion regarding the relative roles of abdominal, vaginal and laparoscopic methods is divided. Hence, a r igorous randomized trial comparing the efficacy and safety of these methods is practicable and urgently needed.