The following is a summary of “Bilateral salpingo-oophorectomy at the time of benign hysterectomy among females with disabilities: A population-based cross-sectional study,” published in the DECEMBER 2023 issue of Obstetrics and Gynecology by Scime, et al.

Concomitant bilateral salpingo-oophorectomy is common during benign hysterectomy in patients aged ≤55 years, exhibiting practice variations influenced by patient health and social factors. Despite the prevalence of disability in premenopausal women and its significant impact on reproductive health, studies examining bilateral salpingo-oophorectomy rates among women with disabilities are scarce. For a study, researchers sought to investigate whether the utilization of concomitant bilateral salpingo-oophorectomy during benign hysterectomy varies based on preexisting disability status in adult females aged ≤55 years.

A population-based cross-sectional study utilized the 2016–2019 US National Inpatient Sample data. The study included females (n=74,315) undergoing inpatient hysterectomy for benign gynecologic indications. Participants were categorized with physical (6.1%), sensory (0.1%), intellectual or developmental (0.2%), or multiple (0.2%) disabilities and compared with those without disabilities. Logistic regression was employed to estimate risk ratios for differences in bilateral salpingo-oophorectomy rates by disability status, adjusting for patient and clinical factors. Models were stratified based on potentially avoidable or appropriate indications for bilateral salpingo-oophorectomy, considering clinical indications for ovarian removal, and further stratified by age group.

In females without disabilities, bilateral salpingo-oophorectomy during benign hysterectomy was observed in 26.0% of cases. Rates were significantly elevated in those with a physical disability (33.2%; adjusted risk ratio, 1.10; 95% CI, 1.05–1.14) and intellectual or developmental disability (31.1%; adjusted risk ratio, 1.32; 95% CI, 1.02–1.64). Rates were possibly elevated in those with multiple disabilities (38.2%; adjusted risk ratio, 1.20; 95% CI, 0.94–1.45) and similar in those with sensory disability (31.2%; adjusted risk ratio, 0.98; 95% CI, 0.83–1.13). For potentially avoidable and potentially appropriate bilateral salpingo-oophorectomy, occurring in 9.1% and 17.0% of females without a disability, respectively, results were similar but with lower statistical precision. The most substantial differences in bilateral salpingo-oophorectomy rates among women with any disability were noted in the perimenopausal 45- to 49-year age group.

Females with disabilities, particularly those with intellectual or developmental disabilities and those in the perimenopausal age group, exhibited elevated rates of concomitant bilateral salpingo-oophorectomy during benign hysterectomy. Some estimates displayed imprecision, emphasizing the need for equity-focused physician training in surgical counseling. Further research into the epidemiology and experiences of gynecologic conditions in females with disabilities could offer valuable insights.

Source: ajog.org/article/S0002-9378(23)00533-1/fulltext