From Sterilization to Ovarian Cancer Prevention: Global Trends, Safety, and Socioeconomic Factors of Opportunistic Salpingectomy During Cesarean Section
DOI:
https://doi.org/10.12775/JEHS.2026.94.73089Keywords
opportunistic salpingectomy, Caesarean section, Complications, contraceptionAbstract
Background: Opportunistic salpingectomy (OS) has rapidly replaced traditional bilateral tubal ligation (BTL) as the highly effective and preferred modality for permanent sterilization but also a concurrent ovarian cancer prophylaxis - as many serous epithelial ovarian cancers are believed to originate in the fallopian tubes rather than the ovaries. However, questions remain regarding safety profiles, racial disparities in procedural access, the long-term preservation of the ovarian endocrine reserve and cost-effectiveness implications
Aim: To synthesize current global trends, oncological benefits, perioperative risks, and socioeconomic factors surrounding OS
Material and methods: A literature search was conducted in the PubMed and Google Scholar database to identify and aggregate studies evaluating the clinical implementation, adverse effects, and complications of OS performed concurrently with Cesarean section, for studies published up to 2026
Results: Total bilateral salpingectomy (TBS) demonstrates up to a 90% risk reduction for Type II high-grade serous carcinomas. The procedure adds 4 to 10 minutes to total operative duration. Furthermore, TBS shows promise for permanent contraception without acutely compromising ovarian reserve, though evidence remains inconclusive. However, a disparity in procedure utilization was observed, with Black patients being approximately 50% less likely than non-Black patients to undergo bilateral salpingectomy for permanent sterilization. At the macroeconomic level, a decision-analytic model of universal OS projected a total healthcare cost-savings of up to $445 million annually within the United States
Conclusions: Opportunistic salpingectomy is a highly cost-effective, oncologically superior, and surgically favorable intervention. To maximize its public health impact, systemic disparities in procedural access must be addressed, and multi-decade prospective tracking is required to confirm lifelong ovarian reserve preservation
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Copyright (c) 2026 Hanna Pelant, Jan Gruszczyński, Kacper Godyń-Müller, Mateusz Kasprzak, Michał Grześkowiak, Joanna Błaszczyk, Zuzanna Majchrzak, Klaudia Pierzyńska, Martin Zeigner, Michał Brzeziński, Bartosz Kulak
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