The Achievability of Bilateral Opportunistic Salpingectomy (BOS) During Non-Descent Vaginal Hysterectomy (NDVH) for Benign Diseases: Insights from a 15-Year Retrospective Analysis at Benha University Hospital.

ahmed, ahmed mousad baioumy; ghareib, Ahmed gamal; Zain Eldin, Ahmed kasem Mohamed; Elmantwe, Ashraf nassif; Darwish, Fatma Faisal Ibrahim

doi:10.21608/bmfj.2025.393449.2474

	The Achievability of Bilateral Opportunistic Salpingectomy (BOS) During Non-Descent Vaginal Hysterectomy (NDVH) for Benign Diseases: Insights from a 15-Year Retrospective Analysis at Benha University Hospital.
Benha Medical Journal
Articles in Press, Accepted Manuscript, Available Online from 25 July 2025 PDF (495.36 K)
Document Type: Original Article
DOI: 10.21608/bmfj.2025.393449.2474
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Authors
ahmed mousad baioumy ahmed¹; Ahmed gamal ghareib²; Ahmed kasem Mohamed Zain Eldin³; Ashraf nassif Elmantwe ⁴; Fatma Faisal Ibrahim Darwish⁵
¹Assistant professor of Obstetrics and Gynecology Department, Benha University Hospital, Benha University Egypt
²Lecturer of obstetrics and gynecology, Benha University hospital, Benha University
³assistant professor of Obstetrics and Gynecology, Benha University
⁴Benha faculty of medicine
⁵assisstant professor of obstetrics and gynecology, Al-Qasr Al-Aini, Cairo University Egypt
Abstract
Background: bilateral salpingectomy (BS) and bilateral salpingo-oophorectomy (BSO) during non-descent vaginal hysterectomy (NDVH) considered technically unfeasible in presence of relative contraindications (RCs). Aim: To evaluate effect of RCs on success of BS/BSO execution during NDVH for benign gynecological conditions. Patients and Methods: This retrospective study included women who consented to NDVH ± BS/BSO for benign indications between 2008 and 2025 at a university hospital and referral private centers. RCs included obesity class III (BMI ≥40 kg/m²), nulliparity, 1-4 cesarean sections (CSs), enlarged uterus (CUS ≥12 weeks, US volume ≥280 cm³, or postoperative uterine weight ≥280 grams), absent uterine descent, known adhesions, negative or limited sliding on transvaginal sonography (TVS), and known adnexal pathology. Results: 1512 undergoing NDVH ± BS/BSO, 485 (32.1%) were in 0RCs and 1027 (67.9%) ≥1 RCs groups. BS/BSO was achieved in 1447 (95.7%) and failed in 65 (4.3%), with no significant difference between groups (95.68% vs. 95.72%, p=0.9). Multivariable logistic regression showed higher odds (OR) of failure with ≥3 CSs (2.45, p=0.0051), ≥4 CSs ( 6.15, p=0.0001), adnexal pathology (3.42, p=0.0035), and limited sliding on TVS (anterior 3.18, p=0.0001; posterior 4.77, p=0.0005). Enlarged uterus showed non-significantly increased odds versus 0RCs, non-enlarged (1.54, p=0.43 and 1.36, p=0.31). Women with ≥4 RCs had significantly higher odds of failure versus 0- 2 RCs (2.38–2.55, p<0.01). Conclusion: NDVH with BS/BSO is feasible and safe, even with RCs. However, women with ≥3 CSs or ≥4 RCs should be counseled about a potentially lower success rate and consider alternative approaches such as vNOTES.
Keywords
non- descent vaginal hysterectomy (NDVH); Bilateral Opportunistic Salpingectomy (BOS); bilateral salpingo-oophorectomy (BSO); vNOTES; ovarian cancer (OC)


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