Take the tubes or not take the tubes? That is the question.
Taking the tubes is not so much of a question now. Data shows that most docs are surgically removing fallopian tubes at the time of hysterectomy for benign causes, such as prolapse surgery.
The reason? Removing both fallopian tubes (aka bilateral salpingectomy) may prevent ovarian cancer. Ovarian cancer is the leading cause of death due to a gynecologic malignancy. Furthermore, ovarian cancer is the 5th most common cause of cancer mortality. Scary. Very scary for the 48.1% of us on earth walking around with ovaries.
The good news is that the most common and most lethal form of ovarian cancer originates in the distal fallopian tubes. From 2008-2013, bilateral salpingectomy has increased by 37%.
Is it safe? A study including 425,180 women (almost half a million) showed no increase in blood transfusion or any other complications with the addition of a bilateral salpingectomy.1
So I say, take the tubes! And I do. In case you are wondering, retaining the ovaries is important when weighing the risks and the benefits. Even postmenopausal ovaries produce hormones that may be cardioprotective. And, according to the World Health Organization, the number one cause of death worldwide is heart disease.2 Far more women die a year from cardiovascular disease than from ovarian cancer. Hence, we leave the ovaries.
- Hanley, G.E., et al., The performance and safety of bilateral salpingectomy for ovarian cancer prevention in the United States. Am J Obstet Gynecol, 2017. 216(3): p. 270 e1-270 e9.
- The top 10 causes of death. 2017 [cited 2017 July 4, 2017]; Available from: http://www.who.int/mediacentre/factsheets/fs310/en/.