Hysterectomy with opportunistic salpingectomy and its influence on structural-functional parameters of ovarian tissue





hysterectomy with salpingectomy, ovarian blood supply disorders, structural and functional parameters of the ovaries, hormonal imbalance after hysterectomy


The study examined the development of posthysterectomy syndrome in patients after hysterectomy with preservation of ovarian tissue.

The aim of the study was to assess the functionality of ovarian tissue in patients with hysterectomy and opportunistic salpingectomy performed for uterine fibroids.

Materials and methods of the research. The study was performed in 160 women of reproductive age. The first group included 90 patients after vaginal hysterectomy with tubectomy and associated with laparoscopy, the second group - 70 patients after abdominal hysterectomy with tubectomy. The control group included 50 women of reproductive age 45.7±1.3 years with asymptomatic fibroids. The diagnostic algorithm included assessment of hormonal status and instrumental study of structural and functional parameters of ovarian tissue both at the stage of preoperative observation and for 12 months, 3 and 5 years after surgery.

Research results and their discussion. At the preoperative stage in both groups found a higher percentage of thyroid disease, hypertension and metabolic disorders, as well as combined proliferative processes of the uterus. Normal ultrasound picture of the ovaries was found in 67.8 % - in the first group and in 47.1 % - in the second group. Significant increase in blood flow in the ovarian artery, in the remote period showing atrophic changes with the development of ovarian depletion syndrome. Assessment of hormonal status in both groups shows marked changes in baseline levels of gonadotropic hormones (FSH and LH): increase in baseline FSH levels by 2.2 times, LH - 1.5 times against the control group (p <0.05), dyshormonal disorders persist for up to 5 years after surgery in one third of cases, and up to 36 months - there is an increase in the proportion of cystic and trophic changes, most pronounced in patients with reduced ovarian reserve, dysmetabolic manifestations and combined proliferative processes of the uterus and appendages before surgery, and syndrome chronic pelvic pain and venous pelvic blood supply in the postoperative period.

Conclusions. The technique of performing a hysterectomy does not have a significant effect on the functional state of the ovaries in the long term. The main indicators of ovarian blood flow and steroid hormone production after hysterectomy with opportunistic salpingectomy for uterine fibroids are close to the reference values up to 36 months postoperatively

Author Biographies

Olha Proshchenko, Bogomolets National Medical University

PhD, Assistant

Department of Obstetrics and Gynecology No. 1

Iryna Ventskivska, Bogomolets National Medical University

Doctor of Medical Sciences, Head of Department

Department of Obstetrics and Gynecology No. 1


  1. Havryliuk, H. M., Makarchuk, O. M. (2016). Posthisterektomichni infringement, prevention and diagnostics. Health of Woman, 7 (113), 52–54.
  2. Madsen, C., Baandrup, L., Dehlendorff, C., Kjaer, S. K. (2014). Tubal ligation and salpingectomy and the risk of epithelial ovarian cancer and borderline ovarian tumors: a nationwide case-control study. Acta Obstetricia et Gynecologica Scandinavica, 94 (1), 86–94. doi: http://doi.org/10.1111/aogs.12516
  3. Preventing Ovarian Cancer. Available at: http://www.ovcare.ca/prevention/ Last accessed: 06.20.2018
  4. Lai, J. C.-Y., Chou, Y.-J., Huang, N., Chen, H.-H., Wang, K.-L., Wang, C.-W. et. al. (2018). The risk of stroke after bilateral salpingo-oophorectomy at hysterectomy for benign diseases: A nationwide cohort study. Maturitas, 114, 27–33. doi: http://doi.org/10.1016/j.maturitas.2018.05.007
  5. McAlpine, J. N., Hanley, G. E., Woo, M. M. M., Tone, A. A., Rozenberg, N., Swenerton, K. D. et. al. (2014). Opportunistic salpingectomy: uptake, risks, and complications of a regional initiative for ovarian cancer prevention. American Journal of Obstetrics and Gynecology, 210 (5), 471.e1–471.e11. doi: http://doi.org/10.1016/j.ajog.2014.01.003
  6. Van Lieshout, L. A. M., Steenbeek, M. P., De Hullu, J. A., Vos, M. C., Houterman, S., Wilkinson, J., Piek, J. M. (2019). Hysterectomy with opportunistic salpingectomy versus hysterectomy alone. Cochrane Database of Systematic Reviews. doi: http://doi.org/10.1002/14651858.cd012858.pub2
  7. Evans, E. C., Matteson, K. A., Orejuela, F. J., Alperin, M., Balk, E. M. et. al. (2016). Salpingo-oophorectomy at the Time of Benign Hysterectomy. Obstetrics & Gynecology, 128 (3), 476–485. doi: http://doi.org/10.1097/aog.0000000000001592
  8. Kruk, O. Y. (2019). The problem of combined diseases in the reproductive system of the women. Reports of Vinnytsia National Medical University, 23 (4), 733–739. doi: http://doi.org/10.31393/reports-vnmedical-2019-23(4)-30
  9. Foulkes, W. D. (2013). Preventing Ovarian Cancer by Salpingectomy. Current Oncology, 20 (3), 139–142. doi: http://doi.org/10.3747/co.20.1613
  10. Hanley, G. E., McAlpine, J. N., Pearce, C. L., Miller, D. (2017). The performance and safety of bilateral salpingectomy for ovarian cancer prevention in the United States. American Journal of Obstetrics and Gynecology, 216 (3), 270.e1–270.e9. doi: http://doi.org/10.1016/j.ajog.2016.10.035
  11. Venturella, R., Lico, D., Borelli, M., Imbrogno, M. G., Cevenini, G., Zupi, E. et. al. (2017). 3 to 5 Years Later: Long-term Effects of Prophylactic Bilateral Salpingectomy on Ovarian Function. Journal of Minimally Invasive Gynecology, 24 (1), 145–150. doi: http://doi.org/10.1016/j.jmig.2016.08.833
  12. Mahal, A. S., Rhoads, K. F., Elliott, C. S., Sokol, E. R. (2017). Inappropriate oophorectomy at time of benign premenopausal hysterectomy. Menopause, 24 (8), 947–953. doi: http://doi.org/10.1097/gme.0000000000000875
  13. Shcherbyna, M. O., Skorbach, O. I., Skorbach, Yu. I., Dynnik, O. O., Kuzmina, O. O. (2017). Clinical metabolic implications ofposthysterectomy syndrome. Zbirnyk naukovykh prats Asotsiatsii akusheriv-hinekolohiv Ukrainy, 2 (40), 296–300.
  14. Falconer, H., Yin, L., Gronberg, H., Altman, D. (2015). Ovarian Cancer Risk After Salpingectomy: A Nationwide Population-Based Study. JNCI Journal of the National Cancer Institute, 107 (2), dju410–dju410. doi: http://doi.org/10.1093/jnci/dju410
  15. Yoon, S.-H., Kim, S.-N., Shim, S.-H., Kang, S.-B., Lee, S.-J. (2016). Bilateral salpingectomy can reduce the risk of ovarian cancer in the general population: A meta-analysis. European Journal of Cancer, 55, 38–46. doi: http://doi.org/10.1016/j.ejca.2015.12.003
  16. Mytton, J., Evison, F., Chilton, P. J., Lilford, R. J. (2017). 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, j372. doi: http://doi.org/10.1136/bmj.j372




How to Cite

Proshchenko, O., & Ventskivska, I. (2022). Hysterectomy with opportunistic salpingectomy and its influence on structural-functional parameters of ovarian tissue. ScienceRise: Medical Science, (2(47), 17–22. https://doi.org/10.15587/2519-4798.2022.256406



Medical Science