Feasibility of Prophylactic Bilateral Salphingectomy during Vaginal Hysterectomy- A Prospective Longitudinal Cohort Study

Abstract

Introduction: Fallopian tubes are not commonly removed during vaginal hysterectomy because of inadequate surgical training or fear of increased morbidity. Aim: The primary objective of this study was to estimate the proportion of planned bilateral salpingectomies successfully completed vaginally. Materials and Methods: This was a prospective, interventional longitudinal cohort study conducted in the Department of Obstetrics and Gynaecology at ESI, PGIMSR, Basaidarapur, New Delhi. From December 2018 to November 2019, all women undergoing vaginal hysterectomy for benign conditions were offered prophylactic salpingectomy. Operative time, blood loss and reason for non completion for salpingectomy were recorded. Patients were followed-up for six weeks. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) 17.0. Continuous variables were described with mean and the categorical variables were described with frequencies and percentages. Results: Thirty-five patients were enrolled in the study. The most common indications for vaginal hysterectomy for benign conditions included uterovaginal prolapse in 21 (60%) patients and adenomyosis and fibroids in 10 (30%) and 4 (10%) patients respectively. Of the 35 patients, vaginal salpingectomy was successful in 31 (88.5%) patients. Factors which led to non completion of salpingectomy were pelvic adhesions and atrophic ovaries in 2 (5.7%) patients each. Mean operating time for bilateral vaginal salpingectomy was 14.05±2.75 minutes. Mean Estimated Blood Loss (EBL) for bilateral salpingectomy was 19.86±6.88 mL. Conclusion: Bilateral prophylactic salpingectomy with vaginal hysterectomy for benign conditions is feasible in most of the patients. Routine salpingectomy should be offered to women undergoing vaginal hysterectomy for benign conditions to prevent risk of ovarian carcinoma in future.