Surgery to prevent ovarian cancer can lead to menopausal symptoms

Every year, approximately 4,000 hysterectomies are performed in Sweden for benign reasons. It has also become common to have surgery on the fallopian tubes during a hysterectomy, to avoid ovarian cancer. This is because ovarian cancer in many cases begins in the fallopian tube, and the disease may be preventable by removing the fallopian tube during uterine surgery.

Ellen Collins' thesis shows that the fallopian tubes are removed during a hysterectomy in just over a third of cases. In a follow-up of previously performed operations, a 35 percent increase in the risk of menopausal symptoms was observed if the fallopian tubes were removed during the operation compared to removal of the uterus only.

The thesis also examined the views and experiences of women awaiting surgery. Women described the care experience and women viewed their problems and upcoming surgery differently. It was difficult to decide what to remove during the operation due to lack of knowledge on the part of women and lack of information from healthcare. Desires varied before surgery, with some expressing the need to remove as little as possible in order to remain healthy, while others wanted to remove as much as possible to prevent future disease.

The thesis states that the effects of removing the fallopian tubes during hysterectomy need further investigation and that the information provided to women before surgery needs to be developed.

Furthermore, the thesis addressed how complications are detected after gynecological surgery in Sweden. Follow-up after gynecological operations in Sweden is carried out through the national quality registry for gynecological surgery, GynOp. Swedish gynecologists have a high level of agreement on how to evaluate potential complications after operations, and GynOp captures more complications than if the numbers were taken from a patient register, as the information is based on communications with healthcare.

The thesis also shows that follow-up after gynecological surgery in Sweden is of good quality and thus serves as a basis for research and follow-up care.

Eileen Collins works as a gynecologist in the Center for Obstetrics and Gynecology at Norland University Hospital, with a focus on gynecologic oncology.