Impact of Opportunistic Salpingectomy on Ovarian Reserve and Vascularity in Patients Undergoing Hysterectomy
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ORIGINAL ARTICLE
Impact of Opportunistic Salpingectomy on Ovarian Reserve and Vascularity in Patients Undergoing Hysterectomy Amita Suneja1
•
Anushree Garg1 • Shuchi Bhatt2 • Kiran Guleria1 • S. V. Madhu3 • Richa Sharma1
Received: 3 August 2020 / Accepted: 18 September 2020 Ó Association of Gynecologic Oncologists of India 2020
Abstract Objective To evaluate the effect of opportunistic salpingectomy on ovarian reserve and vascularity. Methods In this observational study, 45 premenopausal women undergoing hysterectomy were divided into two groups: group 1 (22 patients) with salpingectomy and group 2 (23 patients) without salpingectomy. Serum anti-Mullerian hormone (AMH) estimation and transvaginal sonography were done to assess ovarian Doppler indices prior to and 3 months after surgery. Results Before surgery, median values of AMH (0.45 ng/ml vs 0.44 ng/ml) and ovarian Doppler indices (RI, PI and S/D ratio) were matched in both the groups. The serum AMH levels were decreased by 0.01 ng/ml in group 1 and increased by 0.08 ng/ml in group 2 at 3 months post-surgery (p value 0.19). Positive changes in AMH were seen in 45% versus 65% patients and negative changes in 55% versus 35% patients in both the groups (p value 0.34). Changes (D) in RI (- 0.08 vs - 0.15 p value 0.17), PI (- 0.15 vs - 0.17 p value 0.78) and S/D ratio (- 0.39 vs - 0.35 p value 0.84) from baseline to 3 months postoperatively showed a trend towards increased vascularity and were not found to be significantly different between the two groups. Conclusion Opportunistic salpingectomy did not affect ovarian reserve and vascularity at post 3 months of surgery. Keywords Anti-Mullerian hormone Ovarian reserve Ovarian vascularity Opportunistic salpingectomy Prophylactic salpingectomy
& Amita Suneja [email protected] Anushree Garg [email protected] Shuchi Bhatt [email protected] Kiran Guleria [email protected] S. V. Madhu [email protected] Richa Sharma [email protected] 1
Department of Gynecology and Obstetrics, University College of Medical Sciences (UCMS) and GTB Hospital, University of Delhi, Dilshad Garden, Delhi 110095, India
2
Department of Radiology, UCMS and GTB Hospital, University of Delhi, Dilshad Garden, Delhi 110095, India
3
Department of Endocrinology, UCMS and GTB Hospital, University of Delhi, Dilshad Garden, Delhi 110095, India
Introduction Ovarian cancer has the highest mortality out of all gynaecological cancers, and in India it is the third most common cancer after breast and cervical cancer [1]. Due to the absence of effective screening methods for detecting ovarian cancer at early stage, primary prevention methods are important for reducing cancer-related deaths. There is epidemiological and histopathological evidence regarding the role of fallopian tube in ovarian cancer. Theory of epithelial ovarian carcinogenesis suggests that high-grade serous, high-grade endometroid and clear cell carcinomas are derived from fallopian tube and not directly from ovary [2]. It was observed that women who
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