Opportunistic Salpingectomy and Oophorectomy During Minimally Invasive Sacrocolpopexy

INTRODUCTION: While surgical outcomes of opportunistic salpingectomy and/or oophorectomy for ovarian cancer risk reduction at the time of hysterectomy have been well studied, few studies have examined outcomes at the time of urogynecology and reconstructive pelvic surgery. OBJECTIVE: To evaluate the rates of opportunistic salpingectomy (BS) and salpingo-oophorectomy (BSO) during a minimally invasive approach to sacrocolpopexy (SCP). METHODS: This was a retrospective cohort study performed at an academic, tertiary care center. 185 patient charts were reviewed for those who had undergone a sacrocolpopexy between 2018 and 2023. All sacrocolpopexies occurred via a minimally invasive approach (laparoscopic, robotic single port, or robotic multi-port) and were performed by five urogynecology and reconstructive pelvic surgeons (UPRS) within the same hospital. Charts were reviewed to capture whether a salpingectomy and/or oophorectomy was performed concomitantly. Differences were tested using Wilcoxon rank sum tests and Fisher’s exact tests. RESULTS: The rate of salpingectomy was 85% (91/107) for women with at least one fallopian tube present. The overall rate of oophorectomy was 35% (50/144), and the rate of oophorectomy among women aged 65 or older was 44% (31/71). There was no significant difference in incision to close time between patients who had salpingectomy (p=0.162) or oophorectomy (p=0.826) compared to those who did not undergo adnexal surgery. Additionally, those who did undergo a BS/BSO were more likely to have additional procedures at the time of SCP (both p<0.001). Patients who received oophorectomy at the time of surgery were older on average compared to patients without oophorectomy (mean age 66 vs 61; p=0.011), but age was not significantly different for those who underwent salpingectomy (mean age 61 vs 65; p=0.119). There were no significant differences in BMI, ethnicity/race, or family history of breast or ovarian cancer between groups. CONCLUSIONS: Opportunistic salpingectomy and/or oophorectomy can be considered at the time of sacrocolpopexy. While an optimal rate is not clearly defined, patients should be counseled as to the risks and benefits of opportunistic removal of tubes and/or ovaries.