Table 13.2Oophorectomy undertaken at the time of hysterectomy – non-comparative studies

Bibliographic informationStudy type and evidence levelAim of studyNo. of patientsPopulation characteristicsOutcomesResultsSource of funding and additional comments
Bhavnani 2003543Qualitative interviews

EL = 3
Oophorectomy16Women; waiting for hysterectomy for benign conditions.

Average age = 45

Country: UK
Patient opinions on oophorectomyWomen who want to retain ovaries view them as a healthy organ that does not need removing.

Women who wanted oophorectomy viewed ovaries as source of problems, and needed to be removed.

Women often expressed views that ovaries were ‘worn out’ so should be removed.

Few women talked about long-term impact of oophorectomy for preventing ovarian cancer.

Women who wanted oophorectomy highlighted potential of ovarian cancer.

Women who wanted to retain ovaries often expressed concern about menopause, and want to postpone it as long as possible.

For all women, the health professional played a key role in the evolution of patient preferences.

Women highlighted that it was them who had to raise the issue of oophorectomy.

Women had a variety of sources of information about oophorectomy – books, newspapers, internet and people.
Funding source: NHS R&D programme
Fry 2001253Survey

EL = 3
Factors influencing decision to have oophorectomy58: 30 having oophorectomy, 28 ovarian screeningwomen

Country: UK
Factors related to oophorectomyFrequency of item being rated high or extremely important:

Reducing risk of ovarian cancer, reducing cancer worry, Age, worries about effectiveness of screening, partner's attitude, loss of periods. All at P < 0.05

No difference for other factors – need for HRT, risks of surgery, recovery time, desire for children.
Funding source: Not stated
Hallowell 2000540Interviews

EL = 3
Information needs of women undergoing oophorectomy23Women; Undergone bilateral oophorectomy; pre-menopausal

Country: UK
Themes related to patient information needsInformation needs of women:

Oophorectomy will lead to menopause
What menopausal symptoms to expect
The need to use HRT
Risks and benefits of HRT
Financial cost of long-term prescriptions
Type of surgery being undertaken
Convalescence
Inherited genetic mutations
Funding source: Not stated
Parker 2005604Modelling

EL = 3
Oophorectomy or no oophorectomy; without or with estrogen therapyUnknownWomen undergoing oophorectomy at time of hysterectomy for benign conditionsRisk of mortality by age 80 by hip fracture, ovarian cancer, breast cancer, stroke, coronary heart disease, otherOvarian conservation and no ET vs oophorectomy and no ET vs ovarian conservation and ET vs oophorectomy and ET.

Proportion of women aged 50 to 54 alive at age 80 (%):

Ovarian conservation and no ET = 62.46
Oophorectomy and no ET = 53.88
Ovarian conservation and ET = 62.75
Oophorectomy and ET = 62.15
Funding source: No stated

Study summary: Ovarian conservation until at least age 65 benefits long-term survival for women at average risk of ovarian cancer when undergoing hysterectomy for benign disease.
Wagner 2000539Survey

EL = 3
Opinions on prophylactic oophorectomy and/or mastectomy138 individuals in 35 familiesWomen; BRCA1 or BRCA2 gene mutation

Country: Austria
Willingness to undergo surgery; attitude to surgery; surveillance vs surgery; feelings associated with surgery; effect of surgery on QoL; Motivation in favour of surgery.Women's views about oophorectomy (both affected and non-affected carriers) agree vs disagree:

Willingness to undergo surgery: 30 vs 0
Attitude to surgery: 15 vs
Surveillance vs surgery: 25 vs 4

Feelings associated with surgery:

Anxiety = 15 vs 8
Helplessness = 9 vs 11
Invasion of privacy = 10 vs 13

Effect of surgery on QoL:

General = 13 vs 6
Female identity = 12 vs 12
Sexuality = 11 vs 13

Motivation in favour of surgery:

Future plans = 10 vs 11
Reduced cancer risk = 17 vs 7
Fear of dying of breast cancer = 16 vs 8
Funding source: Not stated

From: Evidence Tables

Cover of Heavy Menstrual Bleeding
Heavy Menstrual Bleeding.
NICE Clinical Guidelines, No. 44.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2007 Jan.
Copyright © 2007, National Collaborating Centre for Women's and Children's Health.

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