Salpingectomy: 5 Reasons Your Provider May Suggest Fallopian Tube Removal
Key takeaways:
Salpingectomy is the process of removing one or both fallopian tubes. It can also help to lower the risk of developing ovarian cancer.
You may need a salpingectomy if your fallopian tubes have abnormalities. This includes infection, swelling, and ectopic pregnancy.
Many providers recommend that people consider salpingectomy when preparing for major gynecologic surgery, like hysterectomy.
A salpingectomy is a surgical procedure to remove one or both fallopian tubes. Fallopian tubes connect the ovaries to the uterus. Ovaries release eggs, and the fallopian tubes serve as a passageway so those eggs can reach the uterus. These tubes are where an egg is fertilized in pregnancy. Then they move to the uterus where they grow.
Salpingectomy is becoming a more popular procedure thanks to its long-lasting benefits. You may have a salpingectomy for a variety of reasons, like birth control, an ectopic pregnancy, or to lessen your risk of cancer.
Let’s take a closer look at five reasons your provider may suggest fallopian tube removal.
1. Ectopic pregnancy
Ectopic pregnancy is a pregnancy that occurs outside of the uterus — where it’s meant to occur. This can happen in the fallopian tubes. Ectopic pregnancy can be life-threatening if not caught early. Bleeding into the abdomen can occur when there’s a large pregnancy in the tube or if the tube breaks. Salpingectomy is then a surgical emergency to remove the damaged tube.
A surgeon may remove only one tube if you want to try to get pregnant in the future — particularly if the remaining tube looks normal. If you're done having children, you may consider having both tubes removed to lower the risk of another ectopic pregnancy.
2. Permanent birth control
If you’re looking for a permanent form of birth control, having a bilateral salpingectomy (both fallopian tubes removed) may be an option. This is an effective form of birth control because the sperm and egg meet and fertilize in the fallopian tube to start a pregnancy. If there’s no tube, the fertilization process doesn’t happen and no pregnancy occurs.
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Tubal ligation, or “getting the tubes tied,” is a form of permanent birth control. It blocks the tubes but leaves them in place. Recent data suggests that removal of the tube (salpingectomy) can be beneficial since it can lower the risk of ovarian cancer.
Dr. Karen C. Wang, assistant professor of gynecology at Johns Hopkins Medicine, says that at this time, for women who desire permanent sterilization, “100% of sterilizations [permanent birth control procedures] are offered salpingectomy due to this benefit.”
Salpingectomy can happen as a stand-alone procedure. Or the tubes can be removed shortly after a vaginal delivery or during a Cesarean section (C-section) birth. It’s easy to remove the tubes when the abdomen is already open from the incision made to deliver a baby. And including a salpingectomy does not raise the surgical risk for the mother or baby.
3. Hydrosalpinx
Hydrosalpinx happens when there’s a buildup of fluid or swelling in the fallopian tubes. This is often diagnosed during a fertility evaluation when a person has some difficulty getting pregnant.
Removing the damaged tube can raise your chance of pregnancy naturally or with assisted reproductive technologies. And it will lower the likelihood of ectopic pregnancy in the abnormal tube.
4. Less ovarian cancer risk
The American College of Obstetrics and Gynecology (ACOG) recommends removing both fallopian tubes when having any type of noncancerous gynecology surgery. This is to lower the lifetime risk of ovarian cancer. Some studies have shown that ovarian cancer begins in the fallopian tubes, so removing them would lower this risk.
Studies show that salpingectomy could lower the risk of ovarian cancer by 65%. This is important to consider because ovarian cancer is the most deadly female reproductive cancer. And it’s often not diagnosed in its early stages. Removing the fallopian tubes has now become a routine part of hysterectomy counseling before the procedure.
5. BRCA genetic mutation
Some people with breast cancer carry a mutation in their BRCA gene. This makes them more likely to develop breast cancer.
If you have a BRCA defect, you may also be at risk for ovarian cancer. And a salpingectomy can significantly lower your risk. If you have the BRCA gene mutation and don’t want to birth children in the future, talk with your provider about removing your tubes.
The bottom line
Salpingectomy is a common procedure to remove one or both fallopian tubes. Your provider may suggest it to treat an ectopic pregnancy, remove a damaged tube, or when you’re considering permanent birth control.
And this procedure can have the added benefit of lowering the risk of ovarian cancer. That’s why providers often recommend it when someone is having a gynecology surgery like hysterectomy. If you’re thinking about salpingectomy, talk with your provider to see if it’s right for you.
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References
American College of Obstetricians and Gynecologists. (2022). Ectopic pregnancy.
American College of Obstetricians and Gynecologists Committee on Gynecologic Practice. (2020). Opportunistic salpingectomy as a strategy for epithelial ovarian cancer prevention.
Falconer, H., et al. (2015). Ovarian cancer risk after salpingectomy: A nationwide population-based study. JNCI: Journal of the National Cancer Institute.
Mills, K., et al. (2021). Salpingectomy vs tubal ligation for sterilization: A systematic review and meta-analysis. American Journal of Obstetrics and Gynecology.
National Cancer Institute Dictionary of Cancer Terms. (n.d.). Fallopian tube.
Pereira, J. M. A. P., et al. (2022). Applicability, safety, and efficiency of salpingectomy versus electrocoagulation and laparoscopic tubal section in ambulatory. Revista Brasileira de Ginecologia e Obstetricia.
Shinar, S., et al. (2017). Total bilateral salpingectomy versus partial bilateral salpingectomy for permanent sterilization during cesarean delivery. Archives of Gynecology and Obstetrics.
Society of Gynecologic Oncology. (2013). SGO clinical practice statement: Salpingectomy for ovarian cancer prevention (SGO, November 2013).
