Hysterectomy plus ovary removal possibly harmful

NEW YORK (Reuters Health) - During hysterectomy operations, surgeons often remove a woman’s ovaries as well as her uterus. But new research suggests that for women are not at high risk for ovarian cancer, removing the ovaries during hysterectomy may adversely impact long-term health.

A scrub technician with surgical instruments is seen in this undated handout photo. REUTERS/Newscom/Handout

Removal of the ovaries at the time of hysterectomy for benign (non-cancerous) disease is often done to prevent the future development of ovarian cancer. While this practice can prevent ovarian cancer, there is also evidence that early menopause induced by ovary removal increases a woman’s risk of developing heart disease.

To investigate the relative pros and cons of ovary removal during hysterectomy, Dr. William H. Parker, from Saint John’s Health Center, Santa Monica, California, and associates analyzed data from 29,380 women enrolled in the long-term Nurses’ Health Study.

A total of 16,345 of the women had their ovaries removed at the time of hysterectomy, while 13,035 had hysterectomy only.

During 24 years of follow-up, the women who had their ovaries removed during hysterectomy appeared to be at higher risk of heart disease, stroke and death, than women who kept their ovaries.

The findings are reported in the May issue of the medical journal Obstetrics & Gynecology.

With ovary removal, the risks of ovarian, breast, and all cancers fell, but, at the same time, the risk of lung cancer and death from any cancer rose.

The investigators estimate that for women who survive 35 years after surgery, one extra death would occur for every nine ovary removal procedures performed.

“Preventive surgery should not be performed if it does not clearly benefit the patient,” the investigators conclude. “Given that approximately 300,000 US women per year undergo elective (ovary removal), these findings have important public health implications.”

SOURCE: Obstetrics and Gynecology, May 2009.