Does retention of the ovaries improve long-term survival after hysterectomy? Prophylactic oophorectomy.

The controversy surrounding prophylactic oophorectomy is discussed. The importance of adequate hormone replacement with estradiol and particularly testosterone is discussed as is the severe limitation of considering publications which describe the unacceptable practice of hysterectomy and bilateral salpingo-oophorectomy without hormone replacement therapy. There remains a good argument for removal of ovaries at hysterectomy in women over the age of 40 with full discussion, consent and appropriate hormone replacement.