Bilateral ovarian removal during hysterectomy: what is done and what should be done

Objective: Discussion of the indications for bilateral removal of the ovaries at hysterectomy after the age of forty. Design: A multicenter survey involving 50 university centres and regional hospitals was carried out. Results: The majority of French Obs-Gyn carry out bilateral removal of adnexa when the patient is over fifty years old, rather than after forty years of age. Discussion: Reducing mortality due to ovarian cancer is commendable, as is the reduction of morbidity due to ovarian cysts and pathology after hysterectomy, but it is necessary to evaluate the cost of prematurely induced menopause. Conclusion: The authors believe that an age limit of forty years is too low. A consensus has emerged for performing bilateral removal of the ovaries after the age of fifty in the absence of a history of pelvic adhesions and/or endometriosis. It is necessary to explore the condition of the ovaries during the laparotomy. (C) 1998 Elsevier Science Ireland Ltd.