Grand Rounds

Salpingectomy vs Tubal Ligation for Sterilization: How Do They Compare?

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BACKGROUND AND PURPOSE:

  • Salpingectomy has been recommended over tubal ligation for sterilization, to reduce risk of ovarian cancer
  • Mills et al. (AJOG, 2020) compared salpingectomy vs tubal ligation with respect to intraoperative characteristics and complication rates 

METHODS:

  • Systematic review and meta-analysis
  • Data sources
    • PubMed | Cochrane Library | Embase | Clinical trials registries
  • Study inclusion criteria
    • RCTs comparing salpingectomy vs tubal ligation in women seeking sterilization with outcomes data
  • Study design
    • Articles were independently assessed by 2 authors
    • Study quality and risk of bias were assessed

RESULTS:

  • 6 studies were included in the qualitative analysis | 5 studies were included in the meta-analysis
    • Quality of the included studies: Mostly good
    • Risk of bias: Low in most studies
  • There were no significant differences for the following
    • Surgical time (3 studies)
      • Mean difference (MD) 7.09 m (95% CI, −8.51 to 22.69; P=0.37)
    • Hospital stay (3 studies)
      • MD −0.01 days (95% CI, −0.54 to 0.53; P = 0.98)
    • Blood loss (3 studies)
      • MD −25.20 mL (95% CI, −125.32 to 74.93; P= 0.62)
    • Change in antimullerian hormone (1 study)
      • MD 0.19 (95% CI, −0.33 to 0.71; P = 0.47)

CONCLUSION:

  • There were no differences noted in efficacy and safety between salpingectomy and tubal ligation
  • However, quantity and quality of data were limited
  • The authors conclude

Given its possible benefits in preventing ovarian cancer, salpingectomy may well become the preferred method for voluntary sterilization in the future

The evidence from our systematic review and meta-analysis supports this view, but further high-quality studies are urgently required

Learn More – Primary Sources:

Salpingectomy vs tubal ligation for sterilization: a systematic review and meta-analysis

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Results of the HYSTUB Trial: What Are the Hormonal Consequences of Opportunistic Salpingectomy?
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