Laughlin-Tommaso Shannon K, Stewart Elizabeth A, Grossardt Brandon R, Rocca Liliana Gazzuola, Rocca Walter A
From the 1Division of Gynecology, Department of Obstetrics and Gynecology;2Department of Surgery; 3Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology; Divisions of 4Biomedical Statistics and Informatics and 5Epidemiology, Department of Health Sciences Research; and 6Department of Neurology, College of Medicine, Mayo Clinic, Rochester, MN.
Menopause. 2014 May;21(5):442-9. doi: 10.1097/GME.0b013e3182a3ff45.
Unilateral oophorectomy (UO) is a common surgical practice, yet it remains understudied. We investigated trends in incidence rates, indications, and pathological differences in the right and left ovaries in women younger than 50 years.
The Rochester Epidemiology Project medical records linkage system was used to identify all women in Olmsted County, MN, who underwent UO between 1950 and 2007 (n = 1,838). We studied the incidence rates, indications, and pathologies of UO by laterality, and investigated trends across time.
Pooling all oophorectomies across a 58-year period, we found that the incidence of UO was higher than the incidence of bilateral oophorectomy through the age of 39 years; however, bilateral oophorectomy surpassed UO thereafter. The incidence of UO increased from 1950 to 1974 but decreased thereafter and was surpassed by the rate of bilateral oophorectomy after 1979. Before 1985, left ovaries were removed more frequently than right ovaries with or without a medical indication for UO. Ovaries removed with a medical indication showed pathological differences between the right ovary and the left ovary, with endometriosis being more common in the left ovary. Ovaries removed without a medical indication did not differ in pathology by side.
There have been major changes in incidence rates of UO across six decades. Medically indicated UO has been more common on the left side due, in part, to the higher prevalence of endometriosis. However, UO without a medical indication has also been more common on the left side because of surgical preferences and traditions. The long-term consequences of right or left UO on timing of menopause, morbidity, and mortality need further study.
单侧卵巢切除术（UO）是一种常见的外科手术，但仍未得到充分研究。我们调查了50岁以下女性右侧和左侧卵巢的发病率、手术指征及病理差异趋势。
利用罗切斯特流行病学项目医疗记录链接系统，确定明尼苏达州奥尔姆斯特德县1950年至2007年间接受UO的所有女性（n = 1838）。我们按左右侧研究了UO的发病率、手术指征和病理情况，并调查了随时间的变化趋势。
汇总58年间所有的卵巢切除术，我们发现，在39岁之前，UO的发病率高于双侧卵巢切除术；然而，此后双侧卵巢切除术超过了UO。UO的发病率在1950年至1974年上升，但此后下降，1979年后被双侧卵巢切除术的发病率超过。1985年前，无论有无医学指征，切除左侧卵巢的频率均高于右侧卵巢。有医学指征切除的卵巢显示右侧卵巢和左侧卵巢存在病理差异，子宫内膜异位症在左侧卵巢更为常见。无医学指征切除的卵巢在病理上无左右差异。
六十年来UO的发病率发生了重大变化。有医学指征的UO在左侧更为常见，部分原因是子宫内膜异位症的患病率较高。然而，无医学指征的UO在左侧也更为常见，这是由于手术偏好和传统。右侧或左侧UO对绝经时间、发病率和死亡率的长期影响需要进一步研究。
