Removing ovaries during hysterectomy: effects remain unknown

During hysterectomy operations, surgeons often remove a woman's ovaries as well as her uterus. Cochrane Researchers now say there is no evidence that removing the ovaries provides any additional benefit and warn surgeons to consider the procedure carefully.

" Until more reliable research is available, removal of the ovaries at the time of hysterectomy should be approached with caution," says lead researcher, Leonardo Orozco of the OBGYN Women's Hospital San José in Costa Rica.

Of those women who undergo hysterectomies aged 40 or above, around half also have their ovaries removed. This amounts to more than 300,000 women a year in the US alone. The reason most commonly given for carrying out an oophorectomy at the same time is that it prevents ovarian cancer. However the ovaries produce not only estrogen, but also important hormones such as androgens that may have important clinical effects which have yet to be identified.

The researchers say there is little evidence to support the idea that removing the ovaries during a hysterectomy provides an overall health benefit. They identified only one controlled trial, involving 362 women. This compared hysterectomies with oophorectomies to hysterectomies without oophorectomies. Although this trial showed a very slight positive effect on psychological well-being when oophorectomies were performed, the team say much more data is required before any conclusions can be drawn.

" There could be a real benefit or harm associated with oophorectomy, but it has not been identified, more research of higher methodological quality is needed." says Orozco.

Source: Wiley-Blackwell, 2008


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