Hysterectomy and removal of fallopian tubes
Question: When a hysterectomy is required, is it necessary for women to have their fallopian tubes removed?
Answer: Hysterectomies are performed frequently in the United States, with more than 500,000 performed each year, according to the American Congress of Obstetricians and Gynecologists. In fact, hysterectomies are the second most common major surgical procedure performed on women of reproductive age, after cesarean sections.
While removal of the fallopian tubes during a hysterectomy is becoming a popular topic of discussion and has been adopted by many surgeons, it's not yet a common practice. There are a few reasons why a woman may have her fallopian tubes removed, including: genetic susceptibility to ovarian cancer, the need for a hysterectomy due to benign disease or tubal ligation, or as the result of an ectopic pregnancy.
A key reason why fallopian tube removal during hysterectomy is being adopted into practice is because of the potential benefits of cancer prevention. New research shows that ovarian cancer may originate in the fallopian tube. In the absence of good screening tests, removal of both fallopian tubes is the only form of prevention for a cancer that is very difficult to detect and often lethal when diagnosed. All patients should know about the option of having the fallopian tubes removed at the time of hysterectomy or if considering permanent sterilization through a tubal ligation.
The function of the fallopian tubes is to provide a pathway for the transportation of sperm and egg so that fertilization can take place. Among factors that women should discuss with their doctors before having their fallopian tubes removed, patients need to be absolutely certain that they have no interest in natural conception.
The removal of the fallopian tubes will render a woman infertile, and will require assisted reproductive technology (IVF) for conception.
Although it is not yet considered the "standard of care" and there are a number of factors to consider, many experts believe that fallopian tube removal should be thoroughly discussed and offered to all patients undergoing major gynecologic surgery, particularly for women who are done with childbearing.
For more information on fallopian tube removal or if you have concerns about reproductive health, talk to your healthcare provider.