The Role of Opportunistic Bilateral Salpingectomy vs Tubal Occlusion or Ligation for Ovarian Cancer Prophylaxis

Bilateral tubal ligation (BTL) for sterilization has been known to decrease the risk of ovarian cancer. Recent studies have suggested that bilateral salpingectomy (BS) may be an alternative to BTL or tubal occlusion for women desiring permanent sterilization, owing to a possibly greater protective effect against ovarian cancer. We conducted a PubMed/MEDLINE review of the literature for original studies, opinion articles, and meta-analyses published between 2010 and 2016 addressing the role of BS at the time of sterilization and comparing its efficacy with BTL in terms of ovarian cancer prevention, operative outcomes, and ovarian function. BTL has been found to decrease the risk of any ovarian cancer by 13% to 41%, compared with 42% to 78% for BS. Although operative time is increased with BS compared with BTL, no differences in complication rates or ovarian reserve between the 2 procedures have been demonstrated. Our review suggests that BS should be discussed when BTL is being considered, and that patients should be counseled about the risks and benefits of both procedures based on the current available evidence.