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| Name | Class |
|---|---|
| Kantonsspital Baden | OTHER |
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Two recently published articles need to be cited to explain the rationale for our study since both studies conclude with contrary findings: The first one is "The post-reproductive Fallopian tube: better removed?" and the other is termed "Factors associated with age of onset and type of menopause in a cohort of UK women".
In essence, while Dietl et al suggest to remove the Fallopian tube routinely in every hysterectomy and every sterilization procedure after 35 yrs of age, Pokoradi et al showed that pelvic surgical procedures and even simple tubal sterilization are associated with an earlier menopause. Hence, this is an important issue as early menopause leads to adverse health status.
Two study findings lead to conflictive points of view. On the one hand a routine removal of the Fallopian tubes is proclaimed to reduce cancer risk, on the other hand we know that surgical pelvic procedures result in early onset of menopause. Pokoradi et al were not able to distinctively tell which part of pelvic surgery (ie hysterectomy, oophorectomy, salpingectomy, tubal ligation?) is affecting menopause because data was not providing surgical details. Nevertheless, Dietl et al's statement "Timing of menopause and other long-term effects have not been studied yet...thus all negative effects are still speculative"1 can only partly be agreed upon regarding Pokoradi's findings. It might be too early to proclaim a routine Fallopian tube removal as long as there is no data on how much this procedure affects ovarian function. This is further supported by another statement in their study "Although most malignant serous "ovarian" carcinomas originate from the distal Fallopian tube, a smaller proportion of serous cancers as well as endometroid, clear cell, mucinous carcinomas are still thought to arise from ovarian surface epithelium.1" which means the exact impact on cancer prophylaxis can only be estimated due to a lack of studies. Other histopathologic entities might not be influenced by tube removal.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Surgery with fallopian tube removal | Active Comparator | Patients receiving routine fallopian tube removal during pelvic surgery after randomization. |
|
| Surgery without fallopian tube removal | No Intervention | Fallopian tubes are not removed during pelvic surgery after randomization. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Routine fallopian tube removal | Procedure | Fallopian tubes are removed by dissection of the Mesosalpinx. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Longitudinal changes of FSH pre- and post-operatively | Follicle-stimulating hormone (U/l) | 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Longitudinal changes of AMH | AMH (anti-mullerian hormone, U/l) | 6 weeks |
| Longitudinal changes of LH | LH (luteinizing hormone, U/l) | 6 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Michael D Mueller, Prof. | University Women's Hospital Bern, Switzerland | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kantonsspital Baden | Baden | 5404 | Switzerland | |||
| University Women's Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21849300 | Result | Dietl J, Wischhusen J, Hausler SF. The post-reproductive Fallopian tube: better removed? Hum Reprod. 2011 Nov;26(11):2918-24. doi: 10.1093/humrep/der274. Epub 2011 Aug 16. | |
| 21514918 | Result | Pokoradi AJ, Iversen L, Hannaford PC. Factors associated with age of onset and type of menopause in a cohort of UK women. Am J Obstet Gynecol. 2011 Jul;205(1):34.e1-13. doi: 10.1016/j.ajog.2011.02.059. Epub 2011 Feb 27. |
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| Longitudinal changes of E2 | E2 (estradiol, U/l) | 6 weeks |
| Longitudinal changes of FSH | Follicle-stimulating hormone (U/l) | 1 year |
| Longitudinal changes of AMH | AMH (anti-mullerian hormone, U/l) | 1 year |
| Longitudinal changes of LH | LH (luteinizing hormone, U/l) | 1 year |
| Longitudinal changes of E2 | E2 (estradiol, U/l) | 1 year |
| Bern |
| 3010 |
| Switzerland |