The place of oophorectomy at vaginal hysterectomy.

A series of 740 vaginal hysterectomies with attempted vaginal oophorectomy is presented and compared with 700 vaginal hysterectomies without oophorectomy. Vaginal oophorectomy was successful in 94% of the patients. Factors influencing the success include obesity, nulliparity, decreased vaginal access and space, lack of uterine descent, increased uterine size and tubo-ovarian disease. These have been analysed and the recognition and management of technical difficulties are described. There was no morbidity attributable to the vaginal oophorectomy. With experience and appropriate technique suitable women can be offered prophylactic oophorectomy at the time of vaginal hysterectomy.