Advertisement
JOGC

No. 377-Hysterectomy for Benign Gynaecologic Indications

      ABSTRACT

      Objective

      To assist physicians performing gynaecologic surgery in decision making surrounding hysterectomy for benign indications.

      Intended Users

      Physicians, including gynaecologists, obstetricians, family physicians, general surgeons, emergency medicine specialists; nurses, including registered nurses and nurse practitioners; medical trainees, including medical students, residents, and fellows; and all other health care providers.

      Target Population

      Adult women (18 years and older) who will undergo hysterectomy for benign gynaecologic indications.

      Options

      The approach to hysterectomy and utility of concurrent surgical procedures are reviewed in this guideline.

      Evidence

      For this guideline relevant studies were searched in the PubMed, Medline, and Cochrane Library databases. The following MeSH search terms and their variations for the last 5 years (2012-2017) were used: vaginal hysterectomy, laparoscopic hysterectomy, robotic hysterectomy, laparoscopically assisted vaginal hysterectomy, total laparoscopic hysterectomy, standard vaginal hysterectomy, and total vaginal hysterectomy.

      Validation methods

      The content and recommendations were drafted and agreed upon by the principal authors and members of the Gynaecology Committee. The Board of the Society of Obstetricians and Gynaecologists of Canada approved the final draft for publication. The quality of evidence was rated using the criteria described in the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology framework (Tables 1 and 2). The Summary of Findings is available upon request.

      Benefits, Harms, and Costs

      Hysterectomy is common, yet surgical practice still varies widely among gynaecologic physicians. This guideline outlines preoperative and perioperative considerations to improve the quality of care for women undergoing benign gynaecologic surgery.

      Guideline Update

      This Society of Obstetricians and Gynaecologists of Canada clinical practice guideline will be automatically reviewed 5 years after publication. However, authors can propose another review date if they feel that 5 years is too short/long based on their expert knowledge of the subject matter.

      Sponsors

      This guideline was developed with resources funded by the Society of Obstetricians and Gynaecologists of Canada.

      Summary Statements

      • 1
        Technicity is defined as the proportion of hysterectomies performed by a minimally invasive route (laparoscopic, laparoscopic-assisted, and vaginal). Increased technicity index is associated with improved surgical quality and patient care (High).
      • 2
        Minimally invasive approaches to hysterectomy are associated with fewer perioperative complications compared to laparotomy (High).
      • 3
        Higher-volume hospitals and surgeons are more likely to have higher technicity and lower complication rates (High).
      • 4
        Same-day discharge protocols following minimally invasive hysterectomy are cost-effective, do not increase complications or re-admission rates, and are associated with high patient satisfaction (Moderate).
      • 5
        Urinary tract injuries are comparable among surgical approaches to hysterectomy (Moderate).
      • 6
        Laparotomy or mini-laparotomy may be appropriate as an alternative approach in specific circumstances depending on patient factors, indication for surgery, and underlying pathology (Moderate).
      • 7
        The risk of vaginal cuff dehiscence is rare and not related to the choice of suture material or route of closure (Moderate).
      • 8
        Supracervical hysterectomy has not been shown to preserve sexual function, decrease pelvic organ prolapse, or reduce incidence of urinary tract injuries compared to total hysterectomy (Moderate).
      • 9
        For women with uterine leiomyomas, preoperative medical treatment with leuprolide acetate or ulipristal acetate can reduce myoma size, decrease bleeding, and correct anemia. Risks and benefits of medical treatment should be discussed preoperatively (High).
      • 10
        Mechanical bowel preparation is not routinely required prior to gynaecologic surgery for benign disease (High).
      • 11
        Removal of normal ovaries at the time of hysterectomy decreases the risk of ovarian cancer but may be associated with health ramifications. Bilateral oophorectomy may lead to acute development of menopausal symptoms in premenopausal women and has not been shown to offer a survival benefit in the absence of genetic predisposition to ovarian cancer (High).
      • 12
        Hysterectomy alone affects ovarian reserve (High).
      • 13
        Opportunistic salpingectomy at the time of hysterectomy is expected to decrease the incidence of high-grade serous ovarian cancer (Low).
      • 14
        There is no strong evidence to support routine uterosacral or vaginal vault suspension at the time of hysterectomy in patients without pelvic organ prolapse (Low).

      Recommendations

      • 1
        Hysterectomy for benign indications should preferably be approached by either vaginal or laparoscopic routes (Strong, High).
      • 2
        Vaginal hysterectomy is still considered the preferred route of hysterectomy, but laparoscopic hysterectomy is an appropriate alternative minimally invasive approach (Strong, Moderate).
      • 3
        Correction of preoperative anemia (hemoglobin <120 g/L) is indicated to reduce morbidity and mortality in the perioperative period when elective surgery is planned (Strong, High).
      • 4
        Preoperative antibiotic prophylaxis and measures to decrease risk of venous thromboembolism are recommended for all patients undergoing hysterectomy (Strong, High).
      • 5
        Women should be counselled about the benefits and risks of removing the ovaries at the time of the hysterectomy. This should include discussion about the risk of ovarian cancer as well as the long-term health implications of earlier menopause linked to bilateral oophorectomy (Strong, Moderate).
      • 6
        Opportunistic salpingectomy can be considered at the time of hysterectomy but the planned surgical approach should not be changed for this sole purpose (Strong, Low).
      • 7
        Urinary tract injury is a known complication of hysterectomy, and clinicians should have a low threshold for further investigation in cases where injury is suspected. Surgeons performing hysterectomy should have access to diagnostic cystoscopy, individually or though consultation, to evaluate for bladder and ureteric integrity (Strong, Moderate).
      • 8
        If patients with endometriosis are planning to undergo hysterectomy, full excision of local endometriosis should be performed concurrently (Strong, Moderate).

      Key Words

      ABBREVIATIONS:

      AH (abdominal hysterectomy), BSO (bilateral salpingo-oophorectomy), CI (confidence interval), GnRHa (gonadotropin-releasing hormone agonist), HR (hazard ratio), LAVH (laparoscopic assisted vaginal hysterectomy), LH (laparoscopic hysterectomy), POP (pelvic organ prolapse), RH (robotic assisted hysterectomy), SBO (small bowel obstruction), SOGC (Society of Obstetricians and Gynaecologists of Canada), TH (total hysterectomy), TI (technicity index), TLH (total laparoscopic hysterectomy), USLS (uterosacral ligament suspension), VH (vaginal hysterectomy)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Obstetrics and Gynaecology Canada
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      REFERENCES

        • Canadian Institute for Health Information
        Inpatient hospitalizations, surgeries, and newborn indicators, 2016-2017.
        Canadian Institute for Health Information, Ottawa2018
        • Lefebvre G
        • Allaire C
        • Jeffrey J
        • et al.
        SOGC clinical guidelines. Hysterectomy.
        J Obstet Gynaecol Can. 2002; 24 (quiz 74–6): 37-61
        • Nieboer TE
        • Johnson N
        • Lethaby A
        • et al.
        Surgical approach to hysterectomy for benign gynaecological disease.
        Cochrane Database Syst Rev. 2009; CD003677
        • Aarts JW
        • Nieboer TE
        • Johnson N
        • et al.
        Surgical approach to hysterectomy for benign gynaecological disease.
        Cochrane Database Syst Rev. 2015; CD003677
        • Schmitt JJ
        • Carranza Leon DA
        • Occhino JA
        • et al.
        Determining optimal route of hysterectomy for benign indications: clinical decision tree algorithm.
        Obstet Gynecol. 2017; 129: 130-138
        • Kovac SR
        • Barhan S
        • Lister M
        • et al.
        Guidelines for the selection of the route of hysterectomy: application in a resident clinic population.
        Am J Obstet Gynecol. 2002; 187: 1521-1527
        • Kovac SR
        Route of hysterectomy: an evidence-based approach.
        Clin Obstet Gynecol. 2014; 57: 58-71
        • Laberge PY
        • Singh SS
        Surgical approach to hysterectomy: introducing the concept of technicity.
        J Obstet Gynaecol Can. 2009; 31: 1050-1053
        • Garry R
        • Fountain J
        • Mason S
        • et al.
        The eVALuate study: two parallel randomised trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy.
        BMJ. 2004; 328: 129
        • Canadian Institute for Health Information
        Health care in Canada.
        Canadian Institute for Health Information, Ottawa2010
        • Chen I
        • Lisonkova S
        • Allaire C
        • et al.
        Routes of hysterectomy in women with benign uterine disease in the Vancouver Coastal Health and Providence Health Care regions: a retrospective cohort analysis.
        CMAJ Open. 2014; 2: E273-E280
        • Gale J
        • Cameron C
        • Chen I
        • et al.
        Increasing minimally invasive hysterectomy: a Canadian academic health centre experience.
        J Obstet Gynaecol Can. 2016; 38: 141-146
        • Mehta A
        • Xu T
        • Hutfless S
        • et al.
        Patient, surgeon, and hospital disparities associated with benign hysterectomy approach and perioperative complications.
        Am J Obstet Gynecol. 2017; 216 (e1–10): 497
        • Chen I
        • Bajzak KI
        • Guo Y
        • et al.
        A national survey of endoscopic practice among gynaecologists in Canada.
        J Obstet Gynaecol Can. 2012; 34: 257-263
        • Mowat A
        • Maher C
        • Ballard E
        Surgical outcomes for low-volume vs high-volume surgeons in gynecology surgery: a systematic review and meta-analysis.
        Am J Obstet Gynecol. 2016; 215: 21-33
        • Ontario Ministry of Health and Long-Term Care
        Quality-based procedures clinical handbook for hysterectomy.
        Ontario Ministry of Health and Long-Term Care, Toronto2016
        • Nensi A
        • Coll-Black M
        • Leyland N
        • et al.
        Implementation of a same-day discharge protocol following total laparoscopic hysterectomy.
        J Obstet Gynaecol Can. 2018; 40: 29-35
        • Korsholm M
        • Mogensen O
        • Jeppesen MM
        • et al.
        Systematic review of same-day discharge after minimally invasive hysterectomy.
        Int J Gynaecol Obstet. 2017; 136: 128-137
      1. ACOG committee opinion no. 444: choosing the route of hysterectomy for benign disease.
        Obstet Gynecol. 2009; 114: 1156-1158
        • AAGL Advancing Minimally Invasive Gynecology Worldwide
        AAGL position statement: route of hysterectomy to treat benign uterine disease.
        J Minim Invasive Gynecol. 2011; 18: 1-3
        • Gendy R
        • Walsh CA
        • Walsh SR
        • et al.
        Vaginal hysterectomy versus total laparoscopic hysterectomy for benign disease: a metaanalysis of randomized controlled trials.
        Am J Obstet Gynecol. 2011; 204 (e1–8): 388
        • Cho HY
        • Park ST
        • Kim HB
        • et al.
        Surgical outcome and cost comparison between total vaginal hysterectomy and laparoscopic hysterectomy for uteri weighing >500 g.
        J Minim Invasive Gynecol. 2014; 21: 115-119
        • Kim HB
        • Song JE
        • Kim GH
        • et al.
        Comparison of clinical effects between total vaginal hysterectomy and total laparoscopic hysterectomy on large uteruses over 300 grams.
        J Obstet Gynaecol Res. 2010; 36: 656-660
        • Candiani M
        • Izzo S
        • Bulfoni A
        • et al.
        Laparoscopic vs vaginal hysterectomy for benign pathology.
        Am J Obstet Gynecol. 2009; 200 (e1–7): 368
        • Ribeiro SC
        • Ribeiro RM
        • Santos NC
        • et al.
        A randomized study of total abdominal, vaginal and laparoscopic hysterectomy.
        Int J Gynaecol Obstet. 2003; 83: 37-43
        • Morelli M
        • Caruso M
        • Noia R
        • et al.
        [Total laparoscopic hysterectomy versus vaginal hysterectomy: a prospective randomized trial].
        Minerva Ginecol. 2007; 59 ([in Italian]): 99-105
        • Drahonovsky J
        • Haakova L
        • Otcenasek M
        • et al.
        A prospective randomized comparison of vaginal hysterectomy, laparoscopically assisted vaginal hysterectomy, and total laparoscopic hysterectomy in women with benign uterine disease.
        Eur J Obstet Gynecol Reprod Biol. 2010; 148: 172-176
        • Ghezzi F
        • Uccella S
        • Cromi A
        • et al.
        Postoperative pain after laparoscopic and vaginal hysterectomy for benign gynecologic disease: a randomized trial.
        Am J Obstet Gynecol. 2010; 203 (e1–8): 118
        • Warren L
        • Ladapo JA
        • Borah BJ
        • et al.
        Open abdominal versus laparoscopic and vaginal hysterectomy: analysis of a large United States payer measuring quality and cost of care.
        J Minim Invasive Gynecol. 2009; 16: 581-588
        • Adelman MR
        • Bardsley TR
        • Sharp HT
        Urinary tract injuries in laparoscopic hysterectomy: a systematic review.
        J Minim Invasive Gynecol. 2014; 21: 558-566
        • Donnez O
        • Jadoul P
        • Squifflet J
        • et al.
        A series of 3190 laparoscopic hysterectomies for benign disease from 1990 to 2006: evaluation of complications compared with vaginal and abdominal procedures.
        BJOG. 2009; 116: 492-500
        • Lindquist SAI
        • Shah N
        • Overgaard C
        • et al.
        Association of previous cesarean delivery with surgical complications after a hysterectomy later in life.
        JAMA Surg. 2017; 152: 1148-1155
        • Hesselman S
        • Hogberg U
        • Jonsson M
        Effect of remote cesarean delivery on complications during hysterectomy: a cohort study.
        Am J Obstet Gynecol. 2017; 217 (e1–8): 564
        • Brummer TH
        • Jalkanen J
        • Fraser J
        • et al.
        FINHYST, a prospective study of 5279 hysterectomies: complications and their risk factors.
        Hum Reprod. 2011; 26: 1741-1751
        • Mamik MM
        • Antosh D
        • White DE
        • et al.
        Risk factors for lower urinary tract injury at the time of hysterectomy for benign reasons.
        Int Urogynecol J. 2014; 25: 1031-1036
        • Adelman MR
        • Bardsley TR
        • Sharp HT
        Urinary tract injuries in laparoscopic hysterectomy: a systematic review.
        J Minim Invasive Gynecol. 2014; 21: 558-566
        • Aarts JW
        • Nieboer TE
        • Johnson N
        • et al.
        Surgical approach to hysterectomy for benign gynaecological disease.
        Cochrane Database Syst Rev. 2015; CD003677
        • Benedetti-Panici P
        • Maneschi F
        • Cutillo G
        • et al.
        Surgery by minilaparotomy in benign gynecologic disease.
        Obstet Gynecol. 1996; 87: 456-459
        • Fanfani F
        • Fagotti A
        • Longo R
        • et al.
        Minilaparotomy in the management of benign gynecologic disease.
        Eur J Obstet Gynecol Reprod Biol. 2005; 119: 232-236
        • Sirisabya N
        • Manchana T
        Minilaparotomy vs laparoscopic hysterectomy for benign gynaecological diseases.
        J Obstet Gynaecol. 2014; 34: 65-69
        • Smith K
        • Caceres A
        Vaginal cuff closure in minimally invasive hysterectomy: a review of training, techniques, and materials.
        Cureus. 2017; 9: e1766
        • Bogliolo S
        • Nadalini C
        • Iacobone AD
        • et al.
        Vaginal cuff closure with absorbable bidirectional barbed suture during total laparoscopic hysterectomy.
        Eur J Obstet Gynecol Reprod Biol. 2013; 170: 219-221
        • Cong L
        • Li C
        • Wei B
        • et al.
        V-Loc 180 suture in total laparoscopic hysterectomy: a retrospective study comparing Polysorb to barbed suture used for vaginal cuff closure.
        Eur J Obstet Gynecol Reprod Biol. 2016; 207: 18-22
        • Einarsson JI
        • Cohen SL
        • Gobern JM
        • et al.
        Barbed versus standard suture: a randomized trial for laparoscopic vaginal cuff closure.
        J Minim Invasive Gynecol. 2013; 20: 492-498
        • Kim JH
        • Byun SW
        • Song JY
        • et al.
        Barbed versus conventional 2-layer continuous running sutures for laparoscopic vaginal cuff closure.
        Medicine (Baltimore). 2016; 95: e4981
        • Medina BC
        • Giraldo CH
        • Riano G
        • et al.
        Barbed suture for vaginal cuff closure in laparoscopic hysterectomy.
        JSLS. 2014; 18: 83-88
        • Health Canada
        Barbed sutures and the potential risk of small bowel obstruction.
        Health Canada, Ottawa2018
        • Hur HC
        • Donnellan N
        • Mansuria S
        • et al.
        Vaginal cuff dehiscence after different modes of hysterectomy.
        Obstet Gynecol. 2011; 118: 794-801
        • Uccella S
        • Ceccaroni M
        • Cromi A
        • et al.
        Vaginal cuff dehiscence in a series of 12,398 hysterectomies: effect of different types of colpotomy and vaginal closure.
        Obstet Gynecol. 2012; 120: 516-523
        • Uccella S
        • Ghezzi F
        • Mariani A
        • et al.
        Vaginal cuff closure after minimally invasive hysterectomy: our experience and systematic review of the literature.
        Am J Obstet Gynecol. 2011; 205 (e1–12): 119
        • Uccella S
        • Malzoni M
        • Cromi A
        • et al.
        Laparoscopic vs transvaginal cuff closure after total laparoscopic hysterectomy: a randomized trial by the Italian Society of Gynecologic Endoscopy.
        Am J Obstet Gynecol. 2018; 218 (e1–13): 500
        • O'Hanlan KA
        • Emeney PL
        • Peters A
        • et al.
        Analysis of a standardized technique for laparoscopic cuff closure following 1924 total laparoscopic hysterectomies.
        Minim Invasive Surg. 2016; 20161372685
        • Lethaby A
        • Mukhopadhyay A
        • Naik R
        Total versus subtotal hysterectomy for benign gynaecological conditions.
        Cochrane Database Syst Rev. 2012; CD004993
        • American College of Obstetricians and Gynecologists
        ACOG committee opinion no. 388: supracervical hysterectomy.
        Obstet Gynecol. 2007; 110: 1215-1217
        • Singh S
        • Best C
        • Dunn S
        • et al.
        Abnormal uterine bleeding in pre-menopausal women.
        J Obstet Gynaecol Can. 2013; 35: 473-475
        • Donnez J
        • Tatarchuk TF
        • Bouchard P
        • et al.
        Ulipristal acetate versus placebo for fibroid treatment before surgery.
        N Engl J Med. 2012; 366: 409-420
        • Donnez J
        • Tomaszewski J
        • Vazquez F
        • et al.
        Ulipristal acetate versus leuprolide acetate for uterine fibroids.
        N Engl J Med. 2012; 366: 421-432
        • Gruson KI
        • Aharonoff GB
        • Egol KA
        • et al.
        The relationship between admission hemoglobin level and outcome after hip fracture.
        J Orthop Trauma. 2002; 16: 39-44
        • Engoren MC
        • Habib RH
        • Zacharias A
        • et al.
        Effect of blood transfusion on long-term survival after cardiac operation.
        Ann Thorac Surg. 2002; 74: 1180-1186
        • Wilson A
        • Yu HT
        • Goodnough LT
        • et al.
        Prevalence and outcomes of anemia in rheumatoid arthritis: a systematic review of the literature.
        Am J Med. 2004; 116: 50S-57S
        • Edna TH
        • Bjerkeset T
        Association between blood transfusion and infection in injured patients.
        J Trauma. 1992; 33: 659-661
        • Shander A
        Anemia in the critically ill.
        Crit Care Clin. 2004; 20: 159-178
        • Triulzi DJ
        • Vanek K
        • Ryan DH
        • et al.
        A clinical and immunologic study of blood transfusion and postoperative bacterial infection in spinal surgery.
        Transfusion. 1992; 32: 517-524
        • Nelson G
        • Altman AD
        • Nick A
        • et al.
        Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS(R)) Society recommendations–part I.
        Gynecol Oncol. 2016; 140: 313-322
        • Richards T
        • Musallam KM
        • Nassif J
        • et al.
        Impact of preoperative anaemia and blood transfusion on postoperative outcomes in gynaecological surgery.
        PLoS One. 2015; e0130861
        • Goodnough LT
        • Shander A
        • Spivak JL
        • et al.
        Detection, evaluation, and management of anemia in the elective surgical patient.
        Anesth Analg. 2005; 101: 1858-1861
        • Van Eyk N
        • van Schalkwyk
        • Infectious Diseases Committee J
        Antibiotic prophylaxis in gynaecologic procedures.
        J Obstet Gynaecol Can. 2012; 34: 382-391
        • Geerts WH
        • Pineo GF
        • Heit JA
        • et al.
        Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy.
        Chest. 2004; 126: 338S-400S
        • Rahn DD
        • Mamik MM
        • Sanses TV
        • et al.
        Venous thromboembolism prophylaxis in gynecologic surgery: a systematic review.
        Obstet Gynecol. 2011; 118: 1111-1125
        • Feng JP
        • Xiong YT
        • Fan ZQ
        • et al.
        Efficacy of intermittent pneumatic compression for venous thromboembolism prophylaxis in patients undergoing gynecologic surgery: a systematic review and meta-analysis.
        Oncotarget. 2017; 8: 20371-20379
        • Gould MK
        • Garcia DA
        • Wren SM
        • et al.
        Prevention of VTE in nonorthopedic surgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines.
        Chest. 2012; 141: e227S—7S
        • Guyatt GH
        • Eikelboom JW
        • Gould MK
        • et al.
        Approach to outcome measurement in the prevention of thrombosis in surgical and medical patients.
        Chest. 2012; 141: e185S-e194S
        • Arnold A
        • Aitchison LP
        • Abbott J
        Preoperative mechanical bowel preparation for abdominal, laparoscopic, and vaginal surgery: a systematic review.
        J Minim Invasive Gynecol. 2015; 22: 737-752
        • Zhang J
        • Xu L
        • Shi G
        Is mechanical bowel preparation necessary for gynecologic surgery? A systematic review and meta-analysis.
        Gynecol Obstet Invest. 2015 Jun 9; ([Epub ahead of print])
        • Eason EL
        • Sampalis JS
        • Hemmings R
        • et al.
        Povidone-iodine gel vaginal antisepsis for abdominal hysterectomy.
        Am J Obstet Gynecol. 1997; 176: 1011-1016
        • Eason E
        • Wells G
        • Garber G
        • et al.
        Antisepsis for abdominal hysterectomy: a randomised controlled trial of povidone-iodine gel.
        BJOG. 2004; 111: 695-699
        • Sarrel PM
        • Sullivan SD
        • Nelson LM
        Hormone replacement therapy in young women with surgical primary ovarian insufficiency.
        Fertil Steril. 2016; 106: 1580-1587
        • Evans EC
        • Matteson KA
        • Orejuela FJ
        • et al.
        Salpingo-oophorectomy at the time of benign hysterectomy: a systematic review.
        Obstet Gynecol. 2016; 128: 476-485
        • Trabuco EC
        • Moorman PG
        • Algeciras-Schimnich A
        • et al.
        Association of ovary-sparing hysterectomy with ovarian reserve.
        Obstet Gynecol. 2016; 127: 819-827
        • Moorman PG
        • Myers ER
        • Schildkraut JM
        • et al.
        Effect of hysterectomy with ovarian preservation on ovarian function.
        Obstet Gynecol. 2011; 118: 1271-1279
        • Canadian Cancer Society's Advisory Committee on Cancer Statistics
        Canadian Cancer Statistics.
        Canadian Cancer Society, Toronto2016
        • Hickey M
        • Ambekar M
        • Hammond I
        Should the ovaries be removed or retained at the time of hysterectomy for benign disease?.
        Hum Reprod Update. 2010; 16: 131-141
        • Rocca WA
        • Gazzuola Rocca L
        • Smith CY
        • et al.
        Bilateral oophorectomy and accelerated aging: cause or effect?.
        J Gerontol A Biol Sci Med Sci. 2017; 72: 1213-1217
        • Phung TK
        • Waltoft BL
        • Laursen TM
        • et al.
        Hysterectomy, oophorectomy and risk of dementia: a nationwide historical cohort study.
        Dement Geriatr Cogn Disord. 2010; 30: 43-50
        • Rocca WA
        • Bower JH
        • Maraganore DM
        • et al.
        Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause.
        Neurology. 2007; 69: 1074-1083
        • Rocca WA
        • Bower JH
        • Maraganore DM
        • et al.
        Increased risk of parkinsonism in women who underwent oophorectomy before menopause.
        Neurology. 2008; 70: 200-209
        • Parker WH
        • Broder MS
        • Chang E
        • et al.
        Ovarian conservation at the time of hysterectomy and long-term health outcomes in the Nurses’ Health Study.
        Obstet Gynecol. 2009; 113: 1027-1037
        • Mytton J
        • Evison F
        • Chilton PJ
        • et al.
        Removal of all ovarian tissue versus conserving ovarian tissue at time of hysterectomy in premenopausal patients with benign disease: study using routine data and data linkage.
        BMJ. 2017; 356: j372
        • Rocca WA
        • Gazzuola-Rocca L
        • Smith CY
        • et al.
        Accelerated accumulation of multimorbidity after bilateral oophorectomy: a population-based cohort study.
        Mayo Clin Proc. 2016; 91: 1577-1589
        • Jacoby VL
        • Grady D
        • Wactawski-Wende J
        • et al.
        Oophorectomy vs ovarian conservation with hysterectomy: cardiovascular disease, hip fracture, and cancer in the Women's Health Initiative Observational Study.
        Arch Intern Med. 2011; 171: 760-768
        • Parker WH
        • Feskanich D
        • Broder MS
        • et al.
        Long-term mortality associated with oophorectomy compared with ovarian conservation in the Nurses’ Health Study.
        Obstet Gynecol. 2013; 121: 709-716
        • Kurman RJ
        • Shih Ie M
        The origin and pathogenesis of epithelial ovarian cancer: a proposed unifying theory.
        Am J Surg Pathol. 2010; 34: 433-443
        • Kindelberger DW
        • Lee Y
        • Miron A
        • et al.
        Intraepithelial carcinoma of the fimbria and pelvic serous carcinoma: evidence for a causal relationship.
        Am J Surg Pathol. 2007; 31: 161-169
        • Salvador S
        • Rempel A
        • Soslow RA
        • et al.
        Chromosomal instability in fallopian tube precursor lesions of serous carcinoma and frequent monoclonality of synchronous ovarian and fallopian tube mucosal serous carcinoma.
        Gynecol Oncol. 2008; 110: 408-417
        • Carlson JW
        • Miron A
        • Jarboe EA
        • et al.
        Serous tubal intraepithelial carcinoma: its potential role in primary peritoneal serous carcinoma and serous cancer prevention.
        J Clin Oncol. 2008; 26: 4160-4165
        • Seidman JD
        • Zhao P
        • Yemelyanova A
        “Primary peritoneal” high-grade serous carcinoma is very likely metastatic from serous tubal intraepithelial carcinoma: assessing the new paradigm of ovarian and pelvic serous carcinogenesis and its implications for screening for ovarian cancer.
        Gynecol Oncol. 2011; 120: 470-473
        • Cass I
        • Holschneider C
        • Datta N
        • et al.
        BRCA-mutation-associated fallopian tube carcinoma: a distinct clinical phenotype?.
        Obstet Gynecol. 2005; 106: 1327-1334
        • Callahan MJ
        • Crum CP
        • Medeiros F
        • et al.
        Primary fallopian tube malignancies in BRCA-positive women undergoing surgery for ovarian cancer risk reduction.
        J Clin Oncol. 2007; 25: 3985-3990
        • Seidman JD
        Serous tubal intraepithelial carcinoma localizes to the tubal-peritoneal junction: a pivotal clue to the site of origin of extrauterine high-grade serous carcinoma (ovarian cancer).
        Int J Gynecol Pathol. 2015; 34: 112-120
        • McAlpine JN
        • Hanley GE
        • Woo MM
        • et al.
        Opportunistic salpingectomy: uptake, risks, and complications of a regional initiative for ovarian cancer prevention.
        Am J Obstet Gynecol. 2014; 210 (e1–11): 471
        • Salvador S
        • Scott S
        • Francis JA
        • et al.
        No. 344-opportunistic salpingectomy and other methods of risk reduction for ovarian/fallopian tube/peritoneal cancer in the general population.
        J Obstet Gynaecol Can. 2017; 39: 480-493
        • Committee on Gynecologic Practice
        Committee opinion no. 620: salpingectomy for ovarian cancer prevention.
        Obstet Gynecol. 2015; 125: 279-281
        • Minig L
        • Chuang L
        • Patrono MG
        • et al.
        Surgical outcomes and complications of prophylactic salpingectomy at the time of benign hysterectomy in premenopausal women.
        J Minim Invasive Gynecol. 2015; 22: 653-657
        • Morelli M
        • Venturella R
        • Mocciaro R
        • et al.
        Prophylactic salpingectomy in premenopausal low-risk women for ovarian cancer: primum non nocere.
        Gynecol Oncol. 2013; 129: 448-451
        • Vorwergk J
        • Radosa MP
        • Nicolaus K
        • et al.
        Prophylactic bilateral salpingectomy (PBS) to reduce ovarian cancer risk incorporated in standard premenopausal hysterectomy: complications and re-operation rate.
        J Cancer Res Clin Oncol. 2014; 140: 859-865
        • Robert M
        • Cenaiko D
        • Sepandj J
        • et al.
        Success and complications of salpingectomy at the time of vaginal hysterectomy.
        J Minim Invasive Gynecol. 2015; 22: 864-869
        • Kotlyar A
        • Gingold J
        • Shue S
        • et al.
        The effect of salpingectomy on ovarian function.
        J Minim Invasive Gynecol. 2017; 24: 563-578
        • Dallenbach P
        • Kaelin-Gambirasio I
        • Jacob S
        • et al.
        Incidence rate and risk factors for vaginal vault prolapse repair after hysterectomy.
        Int Urogynecol J Pelvic Floor Dysfunct. 2008; 19: 1623-1629
        • Rardin CR
        • Erekson EA
        • Sung VW
        • et al.
        Uterosacral colpopexy at the time of vaginal hysterectomy: comparison of laparoscopic and vaginal approaches.
        J Reprod Med. 2009; 54: 273-280
        • Rahn DD
        • Stone RJ
        • Vu AK
        • et al.
        Abdominal hysterectomy with or without angle stitch: correlation with subsequent vaginal vault prolapse.
        Am J Obstet Gynecol. 2008; 199 (e1–4): 669
        • Cruikshank SH
        • Kovac SR
        Randomized comparison of three surgical methods used at the time of vaginal hysterectomy to prevent posterior enterocele.
        Am J Obstet Gynecol. 1999; 180: 859-865
        • Cruikshank SH
        Preventing posthysterectomy vaginal vault prolapse and enterocele during vaginal hysterectomy.
        Am J Obstet Gynecol. 1987; 156: 1433-1440
        • AAGL Advancing Minimally Invasive Gynecology Worldwide
        AAGL practice report: practice guidelines for intraoperative cystoscopy in laparoscopic hysterectomy.
        J Minim Invasive Gynecol. 2012; 19: 407-411
        • Pettit PD
        • Petrou SP
        The value of cystoscopy in major vaginal surgery.
        Obstet Gynecol. 1994; 84: 318-320
        • Dandolu V
        • Mathai E
        • Chatwani A
        • et al.
        Accuracy of cystoscopy in the diagnosis of ureteral injury in benign gynecologic surgery.
        Int Urogynecol J Pelvic Floor Dysfunct. 2003; 14: 427-431
        • Ibeanu OA
        • Chesson RR
        • Echols KT
        • et al.
        Urinary tract injury during hysterectomy based on universal cystoscopy.
        Obstet Gynecol. 2009; 113: 6-10
        • American College of Obstricians and Gynecologists
        ACOG committee opinion. Number 372. July 2007. The role of cystourethroscopy in the generalist obstetrician-gynecologist practice.
        Obstet Gynecol. 2007; 110: 221-224
        • Teeluckdharry B
        • Gilmour D
        • Flowerdew G
        Urinary tract injury at benign gynecologic surgery and the role of cystoscopy: a systematic review and meta-analysis.
        Obstet Gynecol. 2015; 126: 1161-1169
        • Leyland N
        • Casper R
        • Laberge P
        • et al.
        Endometriosis: diagnosis and management.
        J Obstet Gynaecol Can. 2010; 32: S1-32
        • Lamvu G
        Role of hysterectomy in the treatment of chronic pelvic pain.
        Obstet Gynecol. 2011; 117: 1175-1178
        • Solnik MJ
        • Munro MG
        Indications and alternatives to hysterectomy.
        Clin Obstet Gynecol. 2014; 57: 14-42
        • Shakiba K
        • Bena JF
        • McGill KM
        • et al.
        Surgical treatment of endometriosis: a 7-year follow-up on the requirement for further surgery.
        Obstet Gynecol. 2008; 111: 1285-1292
        • MacDonald SR
        • Klock SC
        • Milad MP
        Long-term outcome of nonconservative surgery (hysterectomy) for endometriosis-associated pain in women <30 years old.
        Am J Obstet Gynecol. 1999; 180: 1360-1363
        • Flyckt R
        • Kim S
        • Falcone T
        Surgical management of endometriosis in patients with chronic pelvic pain.
        Semin Reprod Med. 2017; 35: 54-64
        • Namnoum AB
        • Hickman TN
        • Goodman SB
        • et al.
        Incidence of symptom recurrence after hysterectomy for endometriosis.
        Fertil Steril. 1995; 64: 898-902
        • Fedele L
        • Bianchi S
        • Zanconato G
        • et al.
        Tailoring radicality in demolitive surgery for deeply infiltrating endometriosis.
        Am J Obstet Gynecol. 2005; 193: 114-117
        • Rizk B
        • Fischer AS
        • Lotfy HA
        • et al.
        Recurrence of endometriosis after hysterectomy.
        Facts Views Vis Obgyn. 2014; 6: 219-227
        • Tan BK
        • Maillou K
        • Mathur RS
        • et al.
        A retrospective review of patient-reported outcomes on the impact on quality of life in patients undergoing total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis.
        Eur J Obstet Gynecol Reprod Biol. 2013; 170: 533-538
        • Lieng M
        • Qvigstad E
        • Istre O
        • et al.
        Long-term outcomes following laparoscopic supracervical hysterectomy.
        BJOG. 2008; 115: 1605-1610
        • Uccella S
        • Marconi N
        • Casarin J
        • et al.
        Impact of endometriosis on surgical outcomes and complications of total laparoscopic hysterectomy.
        Arch Gynecol Obstet. 2016; 294: 771-778