ObjectiveTo determine the success rate of planned prophylactic adnexectomy at the time of vaginal hysterectomy.MethodsThe same gynecologic surgeon attempted adnexectomy for ovarian cancer prophylaxis in 60 women aged 40 years and older undergoing vaginal hysterectomy between January 1996 and January 1998. A simple vaginal clamp technique was used for salpingo-oophorectomy. Factors such as age and uterine weight and complications were analyzed in this prospective study and compared between women for whom the procedure was successful and for whom it was not.ResultsFifty-three of 60 women (88.3%) underwent successful prophylactic oophorectomy as planned. Women for whom oophorectomy could not be safely performed were significantly older (59.0 years of age vs. 75.3 years of age; 95% confidence interval, −25.0 to −7.7; P = 0.0004) compared to women for whom it was completed as planned. These older women also had significantly smaller uteri (129.6 g vs. 58.6 g; 95% confidence interval, +3.3 to + 138.8; P = 0.04) than their younger counterparts. Complications were rare in each group.ConclusionWith a simple and safe clamp technique the majority of prophylactic oophorectomies can be successfully performed at the time of vaginal hysterectomy. The surgeon must exercise considerable caution when approaching oophorectomy in very elderly women in which severe gonadal atrophy may make oophorectomy too dangerous to perform.