Effects of total salpingectomy performed during hysterectomy on
ovarian blood flow
O. Ozkaya1, M. Sezik1, F. Demir1, H. Toyran Sezik2, H. Kaya1
1Suleyman Demirel University Faculty of Medicine, Department of Obstetrics and
Gynecology, Isparta, Turkey, 2Isparta Maternity and Children’s Hospital, Isparta,
Turkey
Objective To investigate the effects of performing total salpingectomy
during abdominal hysterectomy (without oophorectomy) on ovarian reserve and
blood flow through the ovarian stroma.
Design and methods Twenty-four patients
were recruited and randomized into 2 groups. Group 1 patients (n=12) underwent
total hysterectomy and complete excision of the fallopian tubes bilaterally. In
group 2 (classical approach), fallopian tubes were removed partially leaving
behind the neighboring paraovaraian tissue. Pre- and postoperative (6 months)
serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol
values, ovarian volume estimation by transvaginal ultrasound, and ovarian
stromal blood flow Doppler velocimetry were assessed. Mann-Whitney-U test,
Student’s t test and Freidman’s test were used for comparisons.
Results
Baseline data were similar across the groups (p>0.05). FSH, LH, estradiol
values, and ovarian volume were not changed after both of the techniques.
However, pulsatility index, resistivity index, and systole/diastole (S/D) ratio
were significantly decreased compared to the baseline values in both groups (group
1: p= 0.027, p= 0.018, and p= 0.013, respectively; group 2: p= 0.01, p= 0.002,
and p=0.0001, respectively). Postoperative decline in the S/D ratio was more
pronounced (p=0.007) in group 2 (partial removal).
Conclusion It appears that
complete removal of fallopian tubes during hysterectomy has no effect on ovarian
blood supply. It might be important to protect the ovarian blood supply as much
as possible while performing hysterectomy in the reproductive period. Large
series are required to determine the most appropriate technique that causes the
least impairment on ovarian blood flow.