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Hysterectomy Controversies: Ovarian and Cervical Preservation

JACOBY, VANESSA L. MD, MAS

Clinical Obstetrics & Gynecology: March 2014 - Volume 57 - Issue 1 - p 95–105
doi: 10.1097/GRF.0000000000000011
Hysterectomy 2014: Indications and Techniques

The decision to retain or remove the ovaries and cervix at the time of hysterectomy is complex and controversial. We present a summary of the current literature on the risks and benefits of elective oophorectomy and subtotal hysterectomy to inform surgical decision making. There are no randomized trials of oophorectomy compared with hysterectomy and ovarian preservation. Observational studies have conflicting evidence on long-term health outcomes following oophorectomy. In contrast, there are high-quality randomized trials of subtotal versus total hysterectomy; there is a decrease in some short-term surgical complications for women who undergo subtotal hysterectomy, but no differences in long-term outcomes.

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California

The author declares that there is nothing to disclose.

Correspondence: Vanessa L. Jacoby, MD, MAS, Department of Obstetrics, Gynecology, and Reproductive Sciences University of California, 1635 Divisadero St Suite 600, San Francisco, CA 94115. E-mail: jacobyv@obgyn.ucsf.edu

© 2014 by Lippincott Williams & Wilkins.