Effects of total salpingectomy performed during hysterectomy on ovarian blood flow

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,


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.


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.

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