Bilateral Salpingo-Oophorectomy at Time of Benign Hysterectomy: A Demographic Analysis in an Integrated Healthcare System.

Abstract

Study objective: To characterize temporal trends, demographic variations and clinical factors of bilateral salpingo-oophorectomy (BSO) performed during benign hysterectomy among premenopausal women within the Kaiser Permanente Northern California (KPNC) medical centers.

Design: Retrospective observational study.

Setting: KPNC, a large integrated healthcare delivery organization.

Patients: Women, aged 18 to 50 who underwent a benign hysterectomy within KPNC between 2010 and 2019.

Intervention: Concurrent BSO with hysterectomy.

Measurements and main results: Procedure codes from KPNC Health Connect database were used to identify surgical techniques and demographic data. A total of 28,080 benign hysterectomies were performed; of which, 87.9% (n=24,686) were minimally invasive hysterectomies. BSO occurred in 13.4% (n=3754) of all cases and the annual incidence decreased from 21.6% to 7.1% over the study period. BSO rates were consistently higher across study years in White women, beginning at 25.4% in 2010 and decreasing to 8.7% in 2019. BSO rates by socioeconomic status/Neighborhood Deprivation Index (NDI) showed a steady decline over the study period with no clinically significant difference between NDI quintiles.

Conclusion: This study provides contemporary system-level data describing BSO utilization within an integrated healthcare delivery organization. The decline in premenopausal BSO utilization over the study period, likely reflects evolving clinical practice. Unlike national trends, BSO rates were lower among non-White individuals, and no significant variation in BSO across NDI quintiles were observed.