Qualitative study on the knowledge, attitude and practice on prophylactic oophorectomy among women awaiting hysterectomy for a benign gynecologic lesion

ABSTRACT

Objective: To determine the knowledge, attitude and practice involved in the decision making on prophylactic oophorectomy among women awaiting hysterectomy for a benign disease. Methods: Pre-menopausal women scheduled for hysterectomy in a tertiary government hospital were interviewed regarding their views on prophylactic oophorectomy, menopause and hormone replacement therapy. Results: Seventy percent of women consented to outright hysterectomy with bilateral salpingoophorectomy. Almost half (49%) of the women consenting to oophorectomy have no idea as to the benefits of retaining the ovaries after a hysterectomy. Some women (14%) talked about the long term outcome of oophorectomy such as prevention of ovarian cancer but no women mentioned osteoporosis, breast or cardiac disease and dementia. Others (19%) expressed the fear of having another disease on the ovaries if it will be left behind. Majority of women had no idea about menopause and hormone replacement therapy. Sixty percent of the women left the major influence in making the decision to undergo hystertomy alone or oophorectomy with hysterectomy to their physicians. Conclusion: Most these women are under-informed regarding the benefits the benefits or disadvantages of retaining or removing the ovaries, menopause and hormone replacement therapy. It has become a routine practice to recommend oophorectomy based on age alone. Women who consented to outright oophorectomy relied on the decision of their physicians to proceed with the surgery. In this day and age, patients are far less empowered with information that will make them assume the role of a primary decision maker.