The Prophylactic Adnexectomy

Overview

Objective:
Analysis of the issue of prophylactic bilateral salpingo-oophorectomy (BSO): a) duringpelvic surgery for benign diagnosis; b) in women with hereditary risk of ovarian cancer.Design: Review article.Setting: Department of Obstetric and Gynecology, Charles University.Methods: Critical review of published data.Conclusion: During pelvic surgery for benign diagnosis a prophylactic BSO is indicated of theage over 45, in younger women an individual approach is required, considering many aspects,including history of ovarian and breast cancer. Another indication for BSO is an increased risk offamilial ovarian cancer. The surgery signifi cantly diminished the risk of epithelial cancer of ovary,fallopian tube, and simultaneously the risk of breast cancer. There is a continuing increasedrisk of peritoneal cancer following the surgery. Bilateral oophorectomy together with bilateralsalpingectomy is recommended. The age limit for surgery is about 35 years after careful considerationof individual risk, reproductive plans, type of mutation and age at malignant disease manifestationin previous generation. Potential alternative for women who do not accept prophylacticsurgery is tubal ligation. Screening of risk group or chemoprevention by oral contraceptives are not equivalent alternatives to prophylactic surgery.

Key words:
ovarian cancer, papillary serous carcinoma of peritoneum, screening, prophylacticsalpingo-oophorectomy.