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OOPHORECTOMY: When and Why? A Novel Risk Stratification Tool as an Aid to Decision Making at Gynecological Surgeries

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A Correction to this article was published on 13 March 2024

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Abstract

The decision regarding oophorectomy during gynecological surgeries, especially in perimenopausal and postmenopausal women, has historically posed a significant dilemma. Traditionally, it was widely believed that conserving the ovaries held no benefits, leading to a common practice of recommending bilateral salpingo-oophorectomy alongside hysterectomy for benign conditions in women aged 40–45 and above. Given our evolving comprehension of postmenopausal ovarian function and the genetic susceptibility to ovarian epithelial cancers, the decision regarding oophorectomy poses a dilemma. Oophorectomy is recommended for women with a higher risk of ovarian cancer and ovarian conservation is necessary with women with higher risk of co-morbidities. This paper reviews the available literature on these aspects of oophorectomy. Despite a wealth of literature narrating the advantages and disadvantages of oophorectomy, covering various aspects such as ovarian cancer risk, myocardial infarction incidence, and post-oophorectomy peritoneal cancer, there is a notable absence of a comprehensive evaluation system for risk stratification. The objective of the present paper is to address this gap by consolidating existing literature into a risk stratification system. This system will provide treating physicians a tool that facilitates more informed, case-specific decisions in collaboration with patients and their families. While recognizing that the ultimate decision must be tailored to the individual case and agreed upon mutually by the surgeon, patient, and family, the proposed system seeks to streamline risk stratification. This, in turn, should aid in determining the most suitable course of treatment that maximizes benefits for the patient.

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Acknowledgements

Dr Alpesh Gandhi, President FOGSI and Dr Jaydeep Tank, Secretary General, FOGSI, and Dr. Shalini Warman. This is work of first author in collaboration with FOGSI clinical research committee.

Disclaimer

It represents a general guidance for easy objective decision making for or against oophorectomy based on available evidence on the topic. It does not in any way bind a clinician to follow this evaluation system, and use the risk stratification tool. One can take decision based on discussions with the patient and institution, national or international guidelines.

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  1. The Federation of Obstetric and Gynecological Societies of India (FOGSI), Mumbai, India

    Suvarna Satish Khadilkar & Meena Samant

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  1. Suvarna Satish Khadilkar
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  2. Meena Samant
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Correspondence to Suvarna Satish Khadilkar.

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Suvarna Satish Khadilkar MD DGO FICOG,CIMP, FIMS, Diploma in Endocrinology (UK), Professor and Head of Dept Obgyn, and Consultant Endocrinologist and Gynecologist, Bombay Hospital Institute of Medical Sciences (MUHS Affiliated), Mumbai, She is Deputy Secretary General, FOGSI 2021–2024, Vice President Mumbai Obstetric and Gynecological Society (MOGS) 2022–2024, Secretary, MOGS, 2021–2022, Editor Emeritus, Journal of Obgyn. of India [JOGI] 2021 onwards, Editor In Chief, JOGI, Treasurer FOGSI, 2018–2021, President, Indian Menopause Society-2017, National Secretary, Association of Medical Women of India, 2022–2025, President, Association of Medical Women of India, Mumbai branch, 2011–2016, EDITOR of 12 BOOKS, more than 100 publications, Recipient of more than 30 local national and international Prizes and Awards, She has Delivered many orations, keynote addresses and invited lectures on national and international platforms, Member of FIGO committee on “Well Women Health Care” 2021–2025. Member of Corresponding Editorial Board, JOGR, AOFOG Member, FIGO working group on post reproductive health (WGPRH) 2018–2019, Recognized Teacher, Endocrinology, University of South Wales, UK. Dr. Meena Samant, MD, DNB, MRCOG, Chairperson FOGSI clinical research committee, 2019–2022, Sr consultant and HOD, Dept of Obgyn and.Kurji Holy Family Hospital Patna, India.

The original online version of this article was revised: to update missed corrections provided by author.

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Khadilkar, S.S., Samant, M. OOPHORECTOMY: When and Why? A Novel Risk Stratification Tool as an Aid to Decision Making at Gynecological Surgeries. J Obstet Gynecol India 73, 471–476 (2023). https://doi.org/10.1007/s13224-023-01924-y

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