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Shelley S. Tworoger - One of the best experts on this subject based on the ideXlab platform.
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Tubal Ligation hysterectomy and ovarian cancer a meta analysis
Journal of Ovarian Research, 2012Co-Authors: Megan S. Rice, Megan A. Murphy, Shelley S. TworogerAbstract:Purpose The purpose of this meta-analysis was to determine the strength of the association between gynecologic surgeries, Tubal Ligation and hysterectomy, and ovarian cancer.
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Tubal Ligation, hysterectomy and ovarian cancer:
2012Co-Authors: Megan S. Rice, Megan A. Murphy, Shelley S. TworogerAbstract:Purpose: The purpose of this meta-analysis was to determine the strength of the association between gynecologic surgeries, Tubal Ligation and hysterectomy, and ovarian cancer. Methods: We searched the PubMed, Web of Science, and Embase databases for all English-language articles dated between 1969 through March 2011 using the keywords “ovarian cancer” and “Tubal Ligation” or “Tubal sterilization” or “hysterectomy.” We identified 30 studies on Tubal Ligation and 24 studies on hysterectomy that provided relative risks for ovarian cancer and a p-value or 95% confidence interval (CI) to include in the meta-analysis. Summary RRs and 95% CIs were calculated using a random-effects model. Results: The summary RR for women with vs. without Tubal Ligation was 0.70 (95%CI: 0.64, 0.75). Similarly, the summary RR for women with vs. without hysterectomy was 0.74 (95%CI: 0.65, 0.84). Simple hysterectomy and hysterectomy with unilateral oophorectomy were associated with a similar decrease in risk (summery RR=0.62, 95% CI: 0.49-0.79 and 0.60, 95%CI: 0.47-0.78, respectively). In secondary analyses, the association between Tubal Ligation and ovarian cancer risk was stronger for endometrioid tumors (summary RR=0.45, 95%CI: 0.33, 0.61) compared to serous tumors. Conclusion: Observational epidemiologic evidence strongly supports that Tubal Ligation and hysterectomy are associated with a decrease in the risk of ovarian cancer, by approximately 26-30%. Additional research is needed to determine whether the association between Tubal Ligation and hysterectomy on ovarian cancer risk differs by individual, surgical, and tumor characteristics.
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Abstract B134: Tubal Ligation and ovarian cancer: A meta‐analysis
Epidemiology Lifestyle Factors, 2010Co-Authors: Megan S. Rice, Susan E. Hankinson, Shelley S. TworogerAbstract:Background: While several studies have reported varying associations between Tubal Ligation and ovarian cancer, no recent meta‐analysis has been conducted. In addition, past meta‐analyses have not examined whether study factors, such as study design, or individual factors, such as age at procedure, modify the relationship between ovarian cancer and Tubal Ligation. Methods: We sought to identify all English‐language articles in the PubMed database with quantitative data on the effect of Tubal Ligation and ovarian cancer using the keywords “ovarian cancer” and “Tubal Ligation” or “Tubal sterilization”. We identified 21 articles which provided estimates of the risk of ovarian cancer in relation to Tubal Ligation and six articles which reported stratum‐specific estimates of ovarian cancer risk by age at and years since Tubal Ligation. The summary relative risk (RR) estimate and the 95% confidence interval (CI) for the summary estimate were calculated using a random‐effects model. Tests for homogeneity were used to evaluate the consistency of findings among studies, and Begg9s and Egger9s tests were used to assess publication bias. Results: The RRs for ovarian cancer comparing women who had a Tubal Ligation to those who did not ranged from 0.20 to 2.40 across the studies. The summary RR was 0.68 (95% CI: 0.62–0.75), demonstrating a statistically significant protective effect of Tubal Ligation on ovarian cancer. We found no evidence of heterogeneity by study design (e.g., cohort versus case‐control) or residence of participants (United States vs. non‐United States) as well as no evidence of publication bias. In secondary analyses based on four studies, we did not detect a difference in the risk of ovarian cancer between women who had a Tubal Ligation less than 20 years ago versus 20 or more years ago (p for heterogeneity = 0.65). Similarly, we did not detect effect modification by age ( 35 years of age) at Tubal Ligation (p for heterogeneity = 0.92). Though data were insufficient to calculate summary RRs by histologic subtype, a qualitative examination of study results demonstrated a stronger protective effect of Tubal Ligation for endometroid tumors. Conclusions: Observational epidemiologic evidence strongly suggests that there is a decreased risk of ovarian cancer among women who have had a Tubal Ligation. We found a 30 percent reduction in ovarian cancer among women who had ever had a Tubal Ligation compared to women who have never had a Tubal Ligation. This estimate did not vary by study design or residence of participants. In addition, we did not detect any effect modification by age at Tubal Ligation or years since Tubal Ligation. While there is some evidence that the effect of Tubal Ligation varies by histologic subtype, further research is needed in this area. Citation Information: Cancer Prev Res 2010;3(1 Suppl):B134.
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abstract b134 Tubal Ligation and ovarian cancer a meta analysis
Cancer Prevention Research, 2010Co-Authors: Megan S. Rice, Susan E. Hankinson, Shelley S. TworogerAbstract:Background: While several studies have reported varying associations between Tubal Ligation and ovarian cancer, no recent meta‐analysis has been conducted. In addition, past meta‐analyses have not examined whether study factors, such as study design, or individual factors, such as age at procedure, modify the relationship between ovarian cancer and Tubal Ligation. Methods: We sought to identify all English‐language articles in the PubMed database with quantitative data on the effect of Tubal Ligation and ovarian cancer using the keywords “ovarian cancer” and “Tubal Ligation” or “Tubal sterilization”. We identified 21 articles which provided estimates of the risk of ovarian cancer in relation to Tubal Ligation and six articles which reported stratum‐specific estimates of ovarian cancer risk by age at and years since Tubal Ligation. The summary relative risk (RR) estimate and the 95% confidence interval (CI) for the summary estimate were calculated using a random‐effects model. Tests for homogeneity were used to evaluate the consistency of findings among studies, and Begg9s and Egger9s tests were used to assess publication bias. Results: The RRs for ovarian cancer comparing women who had a Tubal Ligation to those who did not ranged from 0.20 to 2.40 across the studies. The summary RR was 0.68 (95% CI: 0.62–0.75), demonstrating a statistically significant protective effect of Tubal Ligation on ovarian cancer. We found no evidence of heterogeneity by study design (e.g., cohort versus case‐control) or residence of participants (United States vs. non‐United States) as well as no evidence of publication bias. In secondary analyses based on four studies, we did not detect a difference in the risk of ovarian cancer between women who had a Tubal Ligation less than 20 years ago versus 20 or more years ago (p for heterogeneity = 0.65). Similarly, we did not detect effect modification by age ( 35 years of age) at Tubal Ligation (p for heterogeneity = 0.92). Though data were insufficient to calculate summary RRs by histologic subtype, a qualitative examination of study results demonstrated a stronger protective effect of Tubal Ligation for endometroid tumors. Conclusions: Observational epidemiologic evidence strongly suggests that there is a decreased risk of ovarian cancer among women who have had a Tubal Ligation. We found a 30 percent reduction in ovarian cancer among women who had ever had a Tubal Ligation compared to women who have never had a Tubal Ligation. This estimate did not vary by study design or residence of participants. In addition, we did not detect any effect modification by age at Tubal Ligation or years since Tubal Ligation. While there is some evidence that the effect of Tubal Ligation varies by histologic subtype, further research is needed in this area. Citation Information: Cancer Prev Res 2010;3(1 Suppl):B134.
Megan S. Rice - One of the best experts on this subject based on the ideXlab platform.
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Tubal Ligation hysterectomy and ovarian cancer a meta analysis
Journal of Ovarian Research, 2012Co-Authors: Megan S. Rice, Megan A. Murphy, Shelley S. TworogerAbstract:Purpose The purpose of this meta-analysis was to determine the strength of the association between gynecologic surgeries, Tubal Ligation and hysterectomy, and ovarian cancer.
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Tubal Ligation, hysterectomy and ovarian cancer:
2012Co-Authors: Megan S. Rice, Megan A. Murphy, Shelley S. TworogerAbstract:Purpose: The purpose of this meta-analysis was to determine the strength of the association between gynecologic surgeries, Tubal Ligation and hysterectomy, and ovarian cancer. Methods: We searched the PubMed, Web of Science, and Embase databases for all English-language articles dated between 1969 through March 2011 using the keywords “ovarian cancer” and “Tubal Ligation” or “Tubal sterilization” or “hysterectomy.” We identified 30 studies on Tubal Ligation and 24 studies on hysterectomy that provided relative risks for ovarian cancer and a p-value or 95% confidence interval (CI) to include in the meta-analysis. Summary RRs and 95% CIs were calculated using a random-effects model. Results: The summary RR for women with vs. without Tubal Ligation was 0.70 (95%CI: 0.64, 0.75). Similarly, the summary RR for women with vs. without hysterectomy was 0.74 (95%CI: 0.65, 0.84). Simple hysterectomy and hysterectomy with unilateral oophorectomy were associated with a similar decrease in risk (summery RR=0.62, 95% CI: 0.49-0.79 and 0.60, 95%CI: 0.47-0.78, respectively). In secondary analyses, the association between Tubal Ligation and ovarian cancer risk was stronger for endometrioid tumors (summary RR=0.45, 95%CI: 0.33, 0.61) compared to serous tumors. Conclusion: Observational epidemiologic evidence strongly supports that Tubal Ligation and hysterectomy are associated with a decrease in the risk of ovarian cancer, by approximately 26-30%. Additional research is needed to determine whether the association between Tubal Ligation and hysterectomy on ovarian cancer risk differs by individual, surgical, and tumor characteristics.
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Abstract B134: Tubal Ligation and ovarian cancer: A meta‐analysis
Epidemiology Lifestyle Factors, 2010Co-Authors: Megan S. Rice, Susan E. Hankinson, Shelley S. TworogerAbstract:Background: While several studies have reported varying associations between Tubal Ligation and ovarian cancer, no recent meta‐analysis has been conducted. In addition, past meta‐analyses have not examined whether study factors, such as study design, or individual factors, such as age at procedure, modify the relationship between ovarian cancer and Tubal Ligation. Methods: We sought to identify all English‐language articles in the PubMed database with quantitative data on the effect of Tubal Ligation and ovarian cancer using the keywords “ovarian cancer” and “Tubal Ligation” or “Tubal sterilization”. We identified 21 articles which provided estimates of the risk of ovarian cancer in relation to Tubal Ligation and six articles which reported stratum‐specific estimates of ovarian cancer risk by age at and years since Tubal Ligation. The summary relative risk (RR) estimate and the 95% confidence interval (CI) for the summary estimate were calculated using a random‐effects model. Tests for homogeneity were used to evaluate the consistency of findings among studies, and Begg9s and Egger9s tests were used to assess publication bias. Results: The RRs for ovarian cancer comparing women who had a Tubal Ligation to those who did not ranged from 0.20 to 2.40 across the studies. The summary RR was 0.68 (95% CI: 0.62–0.75), demonstrating a statistically significant protective effect of Tubal Ligation on ovarian cancer. We found no evidence of heterogeneity by study design (e.g., cohort versus case‐control) or residence of participants (United States vs. non‐United States) as well as no evidence of publication bias. In secondary analyses based on four studies, we did not detect a difference in the risk of ovarian cancer between women who had a Tubal Ligation less than 20 years ago versus 20 or more years ago (p for heterogeneity = 0.65). Similarly, we did not detect effect modification by age ( 35 years of age) at Tubal Ligation (p for heterogeneity = 0.92). Though data were insufficient to calculate summary RRs by histologic subtype, a qualitative examination of study results demonstrated a stronger protective effect of Tubal Ligation for endometroid tumors. Conclusions: Observational epidemiologic evidence strongly suggests that there is a decreased risk of ovarian cancer among women who have had a Tubal Ligation. We found a 30 percent reduction in ovarian cancer among women who had ever had a Tubal Ligation compared to women who have never had a Tubal Ligation. This estimate did not vary by study design or residence of participants. In addition, we did not detect any effect modification by age at Tubal Ligation or years since Tubal Ligation. While there is some evidence that the effect of Tubal Ligation varies by histologic subtype, further research is needed in this area. Citation Information: Cancer Prev Res 2010;3(1 Suppl):B134.
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abstract b134 Tubal Ligation and ovarian cancer a meta analysis
Cancer Prevention Research, 2010Co-Authors: Megan S. Rice, Susan E. Hankinson, Shelley S. TworogerAbstract:Background: While several studies have reported varying associations between Tubal Ligation and ovarian cancer, no recent meta‐analysis has been conducted. In addition, past meta‐analyses have not examined whether study factors, such as study design, or individual factors, such as age at procedure, modify the relationship between ovarian cancer and Tubal Ligation. Methods: We sought to identify all English‐language articles in the PubMed database with quantitative data on the effect of Tubal Ligation and ovarian cancer using the keywords “ovarian cancer” and “Tubal Ligation” or “Tubal sterilization”. We identified 21 articles which provided estimates of the risk of ovarian cancer in relation to Tubal Ligation and six articles which reported stratum‐specific estimates of ovarian cancer risk by age at and years since Tubal Ligation. The summary relative risk (RR) estimate and the 95% confidence interval (CI) for the summary estimate were calculated using a random‐effects model. Tests for homogeneity were used to evaluate the consistency of findings among studies, and Begg9s and Egger9s tests were used to assess publication bias. Results: The RRs for ovarian cancer comparing women who had a Tubal Ligation to those who did not ranged from 0.20 to 2.40 across the studies. The summary RR was 0.68 (95% CI: 0.62–0.75), demonstrating a statistically significant protective effect of Tubal Ligation on ovarian cancer. We found no evidence of heterogeneity by study design (e.g., cohort versus case‐control) or residence of participants (United States vs. non‐United States) as well as no evidence of publication bias. In secondary analyses based on four studies, we did not detect a difference in the risk of ovarian cancer between women who had a Tubal Ligation less than 20 years ago versus 20 or more years ago (p for heterogeneity = 0.65). Similarly, we did not detect effect modification by age ( 35 years of age) at Tubal Ligation (p for heterogeneity = 0.92). Though data were insufficient to calculate summary RRs by histologic subtype, a qualitative examination of study results demonstrated a stronger protective effect of Tubal Ligation for endometroid tumors. Conclusions: Observational epidemiologic evidence strongly suggests that there is a decreased risk of ovarian cancer among women who have had a Tubal Ligation. We found a 30 percent reduction in ovarian cancer among women who had ever had a Tubal Ligation compared to women who have never had a Tubal Ligation. This estimate did not vary by study design or residence of participants. In addition, we did not detect any effect modification by age at Tubal Ligation or years since Tubal Ligation. While there is some evidence that the effect of Tubal Ligation varies by histologic subtype, further research is needed in this area. Citation Information: Cancer Prev Res 2010;3(1 Suppl):B134.
Pamela Stratton - One of the best experts on this subject based on the ideXlab platform.
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Dysmenorrhea after bilateral Tubal Ligation: a case of retrograde menstruation.
Obstetrics & Gynecology, 2002Co-Authors: Kelly Morrissey, Nadine Idriss, Lynnette K. Nieman, Craig Winkel, Pamela StrattonAbstract:Abstract BACKGROUND: Endometriosis, arising de novo, is believed to be uncommon in women who have undergone bilateral Tubal Ligation because the occluded tube prevents outflow of blood and menses. CASE: A woman 10-year status-post bilateral Tubal Ligation suffered from dysmenorrhea and menorrhagia that began within 1 year after sterilization. At the time of bilateral Tubal Ligation, no endometriosis was observed. A recent magnetic resonance imaging scan showed no pelvic abnormalities, and the patient underwent a diagnostic laparoscopy in anticipation of finding endometriosis, yet none was found. At laparoscopy performed on day 3 of her menstrual cycle, the proximal segments of her occluded fallopian tubes were dilated with blood. As this was the only abnormality found, we postulated that her dysmenorrhea might be related to the dilated proximal Tubal stumps. We evacuated the bloody fluid and occluded the proximal tube at the cornua with Filshie clips. One year after surgery, the patient remains asymptomatic. CONCLUSION: This case is unique because bilateral Tubal Ligation combined with retrograde menstrual flow appears to have caused dysmenorrhea. Women who have undergone Tubal Ligation and who have dysmenorrhea may benefit from a diagnostic laparoscopy during menstruation to evaluate the possibility of retrograde menstruation dilating the proximal Tubal stumps.
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Dysmenorrhea after bilateral Tubal Ligation: a case of retrograde menstruation.
Obstetrics and gynecology, 2002Co-Authors: Kelly Morrissey, Nadine Idriss, Craig Winkel, Lynnette Nieman, Pamela StrattonAbstract:Endometriosis, arising de novo, is believed to be uncommon in women who have undergone bilateral Tubal Ligation because the occluded tube prevents outflow of blood and menses. A woman 10-year status-post bilateral Tubal Ligation suffered from dysmenorrhea and menorrhagia that began within 1 year after sterilization. At the time of bilateral Tubal Ligation, no endometriosis was observed. A recent magnetic resonance imaging scan showed no pelvic abnormalities, and the patient underwent a diagnostic laparoscopy in anticipation of finding endometriosis, yet none was found. At laparoscopy performed on day 3 of her menstrual cycle, the proximal segments of her occluded fallopian tubes were dilated with blood. As this was the only abnormality found, we postulated that her dysmenorrhea might be related to the dilated proximal Tubal stumps. We evacuated the bloody fluid and occluded the proximal tube at the cornua with Filshie clips. One year after surgery, the patient remains asymptomatic. This case is unique because bilateral Tubal Ligation combined with retrograde menstrual flow appears to have caused dysmenorrhea. Women who have undergone Tubal Ligation and who have dysmenorrhea may benefit from a diagnostic laparoscopy during menstruation to evaluate the possibility of retrograde menstruation dilating the proximal Tubal stumps.
Gary D. Davis - One of the best experts on this subject based on the ideXlab platform.
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Microlaparoscopic Tubal Ligation under local anesthesia.
The Journal of the American Association of Gynecologic Laparoscopists, 1998Co-Authors: Nicole Dequattro, Milo L. Hibbert, Jerome L. Buller, Frederick W Larsen, Scott Russell, Stephen E. Poore, Gary D. DavisAbstract:Abstract Local anesthesia to perform laparoscopic Tubal Ligation is of increased interest due to potential safety and cost benefits. We performed Tubal Ligation using microlaparoscopic techniques with local anesthesia and continuous intravenous sedation in 16 women desiring sterilization. Operating and recovery times and patient satisfaction were recorded and compared with values for 30 similar women undergoing microlaparoscopic Tubal Ligation under general anesthesia. Mean±SD operating and recovery times for local and general anesthesia were 29.3±8.1 versus 33.6±11.1 minutes, and 83.9±59.4 versus 114.5±69.8 minutes, respectively. Patient satisfaction was high. The potential for cost savings when performed in an outpatient or clinic setting is significant.
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A microlaparoscopic technique for Pomeroy Tubal Ligation.
Obstetrics and gynecology, 1997Co-Authors: Milo L. Hibbert, Jerome L. Buller, Stephen E. Poore, Stephen D. Seymour, Gary D. DavisAbstract:Objective: To evaluate the efficacy of performing Pomeroy Tubal Ligation using microlaparoscopic techniques. Methods: Thirty-eight consecutive women desiring permanent sterilization underwent laparoscopic Pomeroy Tubal Ligation using small (2 or 5 mm) transumbilical laparoscopes and secondary midline sites (5 mm and 14 gauge). The procedures were performed under general anesthesia (n = 28) or local anesthesia with conscious sedation (n = 10). Results: The mean operative time ± standard deviation (SD) in minutes was 33.0 ± 10.3. The mean recovery time ± SD in minutes was 104.3 ± 41.6. There were no operative complications, and no cases required conversion from the microlaparoscopic technique to a traditional method. Conclusion: The results of this study indicate that the Pomeroy Tubal Ligation may be performed using microlaparoscopic techniques. Furthermore, in selected cases, this technique can be performed under local anesthesia in an outpatient setting.
Megan A. Murphy - One of the best experts on this subject based on the ideXlab platform.
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Tubal Ligation hysterectomy and ovarian cancer a meta analysis
Journal of Ovarian Research, 2012Co-Authors: Megan S. Rice, Megan A. Murphy, Shelley S. TworogerAbstract:Purpose The purpose of this meta-analysis was to determine the strength of the association between gynecologic surgeries, Tubal Ligation and hysterectomy, and ovarian cancer.
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Tubal Ligation, hysterectomy and ovarian cancer:
2012Co-Authors: Megan S. Rice, Megan A. Murphy, Shelley S. TworogerAbstract:Purpose: The purpose of this meta-analysis was to determine the strength of the association between gynecologic surgeries, Tubal Ligation and hysterectomy, and ovarian cancer. Methods: We searched the PubMed, Web of Science, and Embase databases for all English-language articles dated between 1969 through March 2011 using the keywords “ovarian cancer” and “Tubal Ligation” or “Tubal sterilization” or “hysterectomy.” We identified 30 studies on Tubal Ligation and 24 studies on hysterectomy that provided relative risks for ovarian cancer and a p-value or 95% confidence interval (CI) to include in the meta-analysis. Summary RRs and 95% CIs were calculated using a random-effects model. Results: The summary RR for women with vs. without Tubal Ligation was 0.70 (95%CI: 0.64, 0.75). Similarly, the summary RR for women with vs. without hysterectomy was 0.74 (95%CI: 0.65, 0.84). Simple hysterectomy and hysterectomy with unilateral oophorectomy were associated with a similar decrease in risk (summery RR=0.62, 95% CI: 0.49-0.79 and 0.60, 95%CI: 0.47-0.78, respectively). In secondary analyses, the association between Tubal Ligation and ovarian cancer risk was stronger for endometrioid tumors (summary RR=0.45, 95%CI: 0.33, 0.61) compared to serous tumors. Conclusion: Observational epidemiologic evidence strongly supports that Tubal Ligation and hysterectomy are associated with a decrease in the risk of ovarian cancer, by approximately 26-30%. Additional research is needed to determine whether the association between Tubal Ligation and hysterectomy on ovarian cancer risk differs by individual, surgical, and tumor characteristics.
