Is It Necessary to Remove the Ovaries and Fallopian Tubes During a Hysterectomy?

Question

My mother is scheduled for a total vaginal hysterectomy for severe uterine prolapse. The doctor automatically added 'auxiliaries', meaning he wants to remove the ovaries and fallopian tubes, as well. Is it necessary to remove the ovaries and fallopian tubes during a hysterectomy?

Answer

A hysterectomy is a surgery used to remove a woman's uterus. Your mother’s doctor has prescribed a radical hysterectomy, a procedure in which the woman’s cervix, ovaries, and fallopian tubes are removed in addition to her uterus.

Doctors often suggest removing the woman’s ovaries during a hysterectomy in order to prevent her from developing ovarian cancer in the future. The National Women’s Health Network does not consider it to be medically necessary to remove the ovaries unless the patient is at risk for ovarian cancer or has a family history of ovarian cancer. Removing the ovaries can help reduce the risk of ovarian cancer, but it can increase the risk of heart disease and even death.

New research suggests that ovarian cancer actually originates in the fallopian tubes, not the ovaries as was previously thought. For this reason, the American College of Obstetricians and Gynecologists (ACOG) now recommends that the ovaries be preserved and both fallopian tubes removed, during hysterectomy (this is called a bilateral salpingectomy). ACOG believes this practice is a safer and more effective way to lower the risk of developing the most common type of ovarian cancer. Therefore, your mother may choose to have fallopian tubes removed, but to keep her ovaries.

It is best to consider your personal medical history when deciding whether to keep or remove the ovaries during a hysterectomy. This decision should be discussed with your physician in order to weigh the risks and benefits. For more information on hysterectomies, check out our fact sheet.


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