Controversias de la ooforectomía profiláctica bilateral durante la histerectomía electiva
DOI:
https://doi.org/10.51481/amc.v50i3.375Palabras clave:
Ovariectomía, ooforectomía profiláctica, histerectomía, terapia reemplazo hormonalResumen
El término ooforectomía profiláctica implica que los ovarios son normales al ser removidos quirúrgicamente y que se realiza por posibles beneficios futuros, tales como la prevención de cáncer de ovario o evitar reintervenciones quirúrgicas ginecológicas por patología en el anexo remanente. Sin embargo, se ha sugerido que la producción de andrógenos en los ovarios perimenopáusicos tiene un papel prominente en la calidad de vida y el bienestar sexual de la mujer. Al igual que se ha relacionado la ooforectomía bilateral con un aumento en la enfermedad cardiovascular y la mortalidad en mujeres que no usaron terapia de reemplazo hormonal. Hasta que exista evidencia inequívoca proveniente de estudios controlados, aleatorizados y adecuadamente diseñados, la ooforectomía profiláctica bilateral coincidente con una histerectomía electiva en pacientes de bajo riesgo para cáncer de ovario, debe ser considerada con gran cautela. La evidencia actual sugiere que la decisión de realizarla o no durante una histerectomía electiva, se basa más en opinión que en estudios aleatorizados bien diseñados y de peso metodológico, pudiéndose no justificar la realización de tan elevado número de ooforectomías profilácticas en la práctica clínica actual.
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