Total salpingectomy during abdominal hysterectomy: effects on ovarian reserve and ovarian stromal blood flow.
OBJECTIVE
To investigate the short- and medium-term consequences of performing total salpingectomy during abdominal hysterectomy (without oophorectomy) on certain ovarian reserve parameters and blood flow velocity measurements through the ovarian stroma.


METHODS
Twenty-four patients were recruited and randomized into two 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 paraovarian tissue. Pre- and postoperative (at 1 and 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 during the early follicular phase. Mann-Whitney U-test, Student's t-test and Freidman's test were used for comparisons.


RESULTS
Baseline data were similar across the groups (P > 0.05). Mean FSH, LH, estradiol values, and ovarian volume were unchanged after both of the techniques. However, mean pulsatility index, resistance index, and systole/diastole (S/D) ratio were significantly decreased in both groups compared to baseline values (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 mean pulsatility index was more pronounced (P = 0.02) in group 2 (partial removal).


CONCLUSIONS
It appears that complete removal of fallopian tubes during hysterectomy has no advantageous 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.
Sezik
Mekin
M
Department of Obstetrics and Gynecology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey. msezik@yahoo.com
Ozkaya
Okan
O
Demir
Fuat
F
Sezik
Hulya Toyran
HT
Kaya
Hakan
H
D000328:Adult; D001783:Blood Flow Velocity; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007986:Luteinizing Hormone / Q000097:blood; D010053:Ovary / Q000098:blood supply* / Q000000981:diagnostic imaging; D012039:Regional Blood Flow; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone