Management Strategies for the Ovaries at the Time of Hysterectomy for Benign Disease

Abstract

Gynecologists performing hysterectomy for benign disease must universally counsel women about ovarian management. The beneficial effect of elective bilateral salpingo-oophorectomy (BSO) on incident ovarian and breast cancer and elimination of need for subsequent adnexal surgery must be weighed against the risks of ovarian hormone withdrawal. Ovarian conservation rates have increased significantly over the past 15 years. In postmenopausal women, however, BSO can reduce ovarian and breast cancer rates without an adverse impact on coronary heart disease, sexual dysfunction, hip fractures, or cognitive function.

Keywords: BSO; Cardiovascular disease; Elective bilateral salpingo-oophorectomy; Hip fracture; Mortality; Ovarian conservation; Ovarian removal; Sexual function.