Comparison of the Effects of Different Routes of Hysterectomy With Salpingectomy Procedures on the Ovarian Reserve, Ovarian Doppler, and Sexual Function Parameters.

OBJECTIVE

To evaluate the impact of bilateral salpingectomy added to hysterectomy performed via different surgical routes on ovarian reserve, ovarian stromal blood flow, and sexual function in premenopausal women.

METHODS

This prospective longitudinal cohort study included premenopausal women undergoing hysterectomy with bilateral salpingectomy for benign gynecologic indications. Patients were categorized according to surgical approach as laparoscopic hysterectomy (L/S) or abdominal hysterectomy (L/T). Ovarian reserve was assessed using serum anti-Müllerian hormone (AMH) levels preoperatively and at postoperative months 1 and 3. Ovarian stromal blood flow was evaluated bilaterally using color Doppler ultrasonography. Sexual function was assessed using the Female Sexual Function Index (FSFI) preoperatively and at postoperative month 3.

RESULTS

A total of 46 patients were included (26 L/S, 20 L/T). In the L/S group, AMH levels showed no significant change at postoperative months 1 or 3. In the L/T group, a significant decline in AMH was observed at postoperative month 1 (p = 0.043), which was not sustained at month 3. No significant between-group differences were observed in AMH changes. Transient alterations in ovarian Doppler indices were observed, with no persistent differences. FSFI scores improved significantly in both groups, with no differences between surgical approaches.

CONCLUSION

Opportunistic salpingectomy during hysterectomy does not adversely affect ovarian reserve, ovarian stromal blood flow, or sexual function, regardless of surgical route, supporting its safety in premenopausal women.