Salpingectomy is the surgical removal of one or both fallopian tubes. After this procedure, getting pregnant is usually more difficult. There are several reasons to get a salpingectomy, such as preventing ovarian cancer, ectopic pregnancy, tubal blockage, or infection.
The Case for Salpingectomy as Ovarian Cancer Prevention
Recent research has shown that many cases of ovarian cancer actually begin in the fallopian tubes. This research also shows that the most aggressive types of ovarian cancer have origins in the fallopian tubes. So, some people with uteruses who are at high risk of ovarian cancer elect to have their ovaries, fallopian tubes, or both removed as a preventative measure.
Studies show that a salpingectomy can reduce the risk of ovarian cancer by 42% to 78%. Additionally, getting a salpingectomy with a hysterectomy reduces the risk of ovarian cancer by 50%.
Salpingectomy vs. Oophorectomy
Oophorectomy is the surgical removal of the ovaries. Removing the fallopian tubes but leaving the ovaries may be beneficial. This can delay premature menopause or hormonal changes that follow ovary removal.
Studies have shown that the combination of salpingectomy and an oophorectomy results in the lowest cases of ovarian cancer. However, salpingectomy followed by an oophorectomy later resulted in the best quality of life.
Risks of Salpingectomy
Salpingectomy comes with the risks of any surgery, which include the following:
- Infection
- Damage to the surrounding area
- Blood clots
- Uncontrolled bleeding
- Unexpected reaction to anesthesia
Doctors aren't completely sure how the removal of just the fallopian tubes affects hormone production. Studies show that when the tubes are removed for sterilization, hormone production levels of the ovaries don't seem to be affected much. However, if the tubes are removed due to ectopic pregnancy, removal may disrupt the hormone production.
As it is not fully clear how hormone levels can be affected after a salpingectomy, there is a chance of going into premature menopause. But it is lower than that after ovary removal.
Who Should Get a Salpingectomy?
Many people with the BRCA1 or BRCA2 gene mutations, which cause an increased risk of ovarian and breast cancer, get a salpingectomy.
About 13% of people with breasts can get breast cancer. However, people with BRCA gene mutations have a 45% to 72% risk of breast cancer. The risk of ovarian cancer is also higher. Generally, 1.2% of people with uteruses get ovarian cancer. But people with BRCA gene mutations have an 11% to 44% risk of ovarian cancer. Removing the fallopian tubes can reduce the risk of both these cancers.
Otherwise, people with the following conditions may need a salpingectomy:
- Blocked fallopian tube
- Ectopic pregnancy
- Endometriosis
- Fallopian tube cancer
- Antibiotic-resistant fallopian tube infection
Salpingectomy Recovery
With laparoscopy, the procedure lasts about 1.5 hours. You may go home the same day as the procedure. Most people can go back to work after a few days. After 2 weeks, you can return to all of your normal activities.
While you are recovering, seek medical attention if you have any of the following symptoms:
- Painful urination
- Burning when urinating
- Fever
- Chills
- Redness at the incision site
- Swelling at the incision site
- Fluid leaking from the incision
- Excessive bleeding
- Pain that is not helped by medication
- Swelling, redness, or pain in your legs
Getting Pregnant After a Salpingectomy
After having your fallopian tubes removed, you can get pregnant using in-vitro fertilization (IVF). This process involves collecting eggs from your ovaries, fertilizing them in a lab to create embryos, and then implanting those embryos into your uterus.
The success rate of IVF depends on your age and other health factors. However, one study has shown that there is little difference in IVF success rates between people who have had salpingectomies and those who have not.