Incidence, time trends, laterality, indications, and pathological findings of unilateral oophorectomy before menopause - PubMed (original) (raw)

Shannon K Laughlin-Tommaso et al. Menopause. 2014 May.

Abstract

Objective: Unilateral oophorectomy (UO) is a common surgical practice, yet it remains understudied. We investigated trends in incidence rates, indications, and pathological differences in the right and left ovaries in women younger than 50 years.

Methods: The Rochester Epidemiology Project medical records linkage system was used to identify all women in Olmsted County, MN, who underwent UO between 1950 and 2007 (n = 1,838). We studied the incidence rates, indications, and pathologies of UO by laterality, and investigated trends across time.

Results: Pooling all oophorectomies across a 58-year period, we found that the incidence of UO was higher than the incidence of bilateral oophorectomy through the age of 39 years; however, bilateral oophorectomy surpassed UO thereafter. The incidence of UO increased from 1950 to 1974 but decreased thereafter and was surpassed by the rate of bilateral oophorectomy after 1979. Before 1985, left ovaries were removed more frequently than right ovaries with or without a medical indication for UO. Ovaries removed with a medical indication showed pathological differences between the right ovary and the left ovary, with endometriosis being more common in the left ovary. Ovaries removed without a medical indication did not differ in pathology by side.

Conclusions: There have been major changes in incidence rates of UO across six decades. Medically indicated UO has been more common on the left side due, in part, to the higher prevalence of endometriosis. However, UO without a medical indication has also been more common on the left side because of surgical preferences and traditions. The long-term consequences of right or left UO on timing of menopause, morbidity, and mortality need further study.

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Conflict of interest statement

Conflict of interest/financial disclosure: None of the authors have any financial disclosures.

Figures

Figure 1

Figure 1

Incidence rates of unilateral oophorectomy and bilateral oophorectomy in Olmsted County, Minnesota, from 1950 to 2007. Incidence rates are shown across age groups (panel A; average age-specific incidence rates over a 58-year period) and across calendar year groups (panel B; calendar year-specific incidence rates). Unilateral oophorectomy incidence rates are also shown separately for the left and the right ovary. Incidence rates across calendar year are age-standardized to the total population from the 2000 US Census. The data on the incidence of bilateral oophorectomy were derived from a previous study in Olmsted County, Minnesota . Note that the y-axis scale differs between panel A and panel B.

Figure 2

Figure 2

Time trends in the incidence of unilateral oophorectomy by age group and laterality in Olmsted County, Minnesota, from 1950 to 2007. Panels A and D show trends for all unilateral oophorectomies combined. Panels B and E show the incidence of unilateral oophorectomy with an ovarian medical indication, and panels C and F show the incidence of unilateral oophorectomy without a specified ovarian medical indication. Incidence is shown for women younger than 40 years (top panels A, B, and C) and for women age 40–49 years (bottom panels D, E, and F).

Figure 3

Figure 3

Time trends in the incidence of unilateral oophorectomy by age group and hysterectomy status in Olmsted County, Minnesota, from 1950 to 2007. Incidence is shown for women younger than 40 years (panel A) and women age 40–49 years (panel B).

Comment in

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