title: [Prophylactic adnexectomy].
abstract: OBJECTIVE
  Analysis of the issue of prophylactic bilateral salpingo-oophorectomy (BSO): a) during pelvic surgery for benign diagnosis; b) in women with hereditary risk of ovarian cancer.
  
  
  METHODS
  Review article.
  
  
  METHODS
  Department of Obstetric and Gynecology, Charles University.
  
  
  METHODS
  Critical review of published data.
  
  
  CONCLUSIONS
  During pelvic surgery for benign diagnosis a prophylactic BSO is indicated of the age over 45, in younger women an individual approach is required, considering many aspects, including history of ovarian and breast cancer. Another indication for BSO is an increased risk of familial ovarian cancer. The surgery significantly diminished the risk of epithelial cancer of ovary, fallopian tube, and simultaneously the risk of breast cancer. There is a continuing increased risk of peritoneal cancer following the surgery. Bilateral oophorectomy together with bilateral salpingectomy is recommended. The age limit for surgery is about 35 years after careful consideration of individual risk, reproductive plans, type of mutation and age at malignant disease manifestation in previous generation. Potential alternative for women who do not accept prophylactic surgery is tubal ligation. Screening of risk group or chemoprevention by oral contraceptives are not equivalent alternatives to prophylactic surgery.
authors.affiliation: Gynekologicko-porodnická klinika I. LF UK a VFN, Praha.
authors.forename: D
authors.initials: D
authors.lastname: Cibula
authors.forename: J
authors.initials: J
authors.lastname: Novotný
authors.forename: D
authors.initials: D
authors.lastname: Fischerová
authors.forename: P
authors.initials: P
authors.lastname: Freitag
authors.forename: M
authors.initials: M
authors.lastname: Zikán
authors.forename: N
authors.initials: N
authors.lastname: Jancárková
authors.forename: L
authors.initials: L
authors.lastname: Petruzelka
authors.forename: J
authors.initials: J
authors.lastname: Zivný
mesh_terms: D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control*; D010052:Ovariectomy; D012307:Risk Factors