Abstract:

The merits of prophylactic oophorectomy at the time of hysterectomy have been debated for many years. The most compelling argument for prophylactic removal of the ovaries has always been the prevention of ovarian cancer (2). Prophylactic oophorectomy has advantages and disadvantages. The actual incidence of cancer in retained ovaries is difficult to estimate. The advantages of prophylactic oophorectomy include the prevention of ovarian cancer, the alleviation of symptoms from residual ovary syndrome and the elimination of the need for reoperation for adnexal disease (2). Disadvantages include surgical castration, which results in the need for hormone replacement, and changes in self-image (2). In addition, when oophorectomy is performed, the germinal, steroidal and hormonal functions of the ovary are lost, but the nonsteroidal functions continue during natural menopause. Prophylactic oophorectomy in premenopausal women induces surgical menopause, requiring estrogen replacement to prevent symptoms and diseases associated with menopause (2). Consideration should be given to prophylactic oophorectomy in younger women undergoing pelvic surgery if they have high risk factors (3). Although prophylactic oophorectomy may not completely eliminate the potential for intraabdominal carcinomatosis (4), it remains an effective strategy for the prevention of ovarian cancer. The use of this approach is not limited by age. Advances in medical technology, especially in medical genetics, have led to potentially useful techniques for the early detection of epithelial ovarian cancer and high risk women.

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