Transvaginal mobilization and removal of ovaries and fallopian tubes after vaginal hysterectomy

OBJECTIVE: To describe a technique of transvaginal mobilization and removal of ovaries and tubes, and to assess its use in older women undergoing vaginal hysterectomy. METHODS: Charts of 151 women age 50 and older who underwent vaginal hysterectomy by one senior gynecologic surgeon during 1991-1993 were reviewed. RESULTS: Ninety of 138 women (65%) who chose ovarian removal had their ovaries successfully removed vaginally. In 48 women, one or both ovaries were examined and noted to be normal, and they were not removed or could not be removed vaginally. Operating time, estimated blood loss, length of hospital stay, and rates of intraoperative complications and postoperative morbidity did not differ significantly in the bilateral salpingo-oophorectomy and ovarian conservation groups. CONCLUSION: Transvaginal removal of ovaries and tubes can be achieved in about two-thirds of women undergoing vaginal hysterectomy with minimal or no increases in operating time and surgical morbidity.