THE CONTROVERSIAL OVARY

Routine removal of ovaries at hysterectomy has been urged as a means of preventing ovarian carcinoma. Proponents of this policy, however, have not submitted the crucial datum: What proportion of women undergoing hysterectomy for benign conditions will later have ovarian carcinoma if the ovaries are not removed. Granting that oophorectomy will effectively prevent ovarian carcinoma, it creates an endocrine imbalance that cannot be corrected artificially, and the lack of ovarian hormones may precipitate osteoporosis or cardiovascular disease. If the ovaries appear normal, if there is no history of carcinoma, and if the patient understands and accepts the risk, the ovaries usually can be conserved at hysterectomy for benign conditions.