title: Factors affecting the feasibility of bilateral salpingo-oophorectomy during vaginal hysterectomy for uterine prolapse.
abstract: BACKGROUND
  About 15% of all hysterectomies are performed for pelvic organ prolapse, generally through the transvaginal approach. However, concomitant bilateral salpingo-oophorectomy (BSO) is not always feasible through this approach, because the adnexae are sometimes inaccessible.
  
  
  OBJECTIVE
  To identify factors affecting the feasibility of performing BSO during transvaginal hysterectomy for uterine prolapse.
  
  
  METHODS
  We reviewed charts of all women undergoing vaginal hysterectomy for uterine prolapse in our institution between December 2005 and November 2009, at which time BSO was uniformly attempted in all patients.
  
  
  RESULTS
  One hundred and seventy-two women who underwent vaginal hysterectomy were identified, of whom 134 (78%) underwent concomitant BSO. Women in whom BSO was feasible were younger (60.6±10.1 vs 65.6±8.6 years, P<0.02) and had a higher prevalence of advanced prolapse, including stage IV cystocele (68% vs 38%, P=0.01), stage III-IV rectocele (40% vs 11%, P=0.003) and stage IV uterine prolapse (64% vs 25%, P=0.0005).
  
  
  CONCLUSIONS
  The feasibility of BSO was primarily dependent on the stage of pelvic organ prolapse and patients' age. Relaxation of the adnexae because of weakness of the infundibulo-pelvic ligaments may accompany severe pelvic organ prolapse and may potentially explain the feasibility of BSO in these women.
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Carmel Medical Center, Technion University, Rappaport Faculty of Medicine, Haifa, Israel.
authors.forename: Lena
authors.initials: L
authors.lastname: Dain
authors.forename: Yoram
authors.initials: Y
authors.lastname: Abramov
mesh_terms: D000367:Age Factors; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D008875:Middle Aged; D010052:Ovariectomy; D011379:Prognosis; D012189:Retrospective Studies; D058994:Salpingectomy; D014596:Uterine Prolapse / Q000473:pathology / Q000601:surgery*