Trends of Bilateral Salpingectomy During Vaginal Hysterectomy With and Without Laparoscopic Assistance Performed for Benign Indications in the United States.

STUDY OBJECTIVE

To estimate the recent temporal trends of concurrent bilateral salpingectomy (BS) during vaginal hysterectomy (total vaginal hysterectomy [TVH] and laparoscopic-assisted vaginal hysterectomy [LAVH]) in the United States.

DESIGN

A cross-sectional analysis was conducted using data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample, including all female patients 18 years and older whose inpatient discharge record indicated a TVH or LAVH performed for benign indications between January 1, 1998, and December 31, 2011. Joinpoint regression was used to identify statistically significant changes in overall and subgroup temporal trends of TVH and LAVH as well as concomitant BS during the 14-year study period (Canadian Task Force Classification II).

SETTING

Not applicable.

PATIENTS

All patients who underwent TVH and LAVH from 1998 to 2011 registered in the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database.

INTERVENTIONS

Not applicable.

MEASUREMENTS AND MAIN RESULTS

Regarding TVH, between 1998 and 2001, there was a steep negative trend with an annual percentage change of -5.2 (95% confidence interval [CI], -8.8 to -2.2). From 2001 to 2011, the negative trend was still observed but with a more gradual 2% annual decrease (95% CI, -2.4 to -1.3). Conversely, the rate of LAVH increased at a rate of 4.4% each year (95% CI, 3.7-5.0). From 1998 to 2004, the national rate of BS during TVH increased sharply with an annual increase of 42.8% (95% CI, 22.7-66.3). Beginning in 2004, the BS rate during TVH decreased and remained stable. During LAVH, the rate of concomitant BS increased an estimated 15% each year during the entire study period (95% CI, 11.9-17.8).

CONCLUSION

The proportion of annual LAVH with concomitant BS procedures performed across the nation is on the rise while TVH is declining with a stable rate of concomitant BS.