ObjectivesThis article determines whether an oophorectomy, when performed during vaginal hysterectomy, increases perioperative morbidity compared with a vaginal hysterectomy without oophorectomy.MethodsThe records of 1026 patients who had undergone vaginal hysterectomy, with or without vaginal oophorectomy, were reviewed.ResultsA total of 490 women underwent attempted vaginal oophorectomy. The removal of one or both ovaries was accomplished in 440 patients (90%). The removal of both ovaries was possible in 410 patients (84%). The vaginal removal of only one ovary when the removal of two ovaries was attempted was accomplished in 30 patients (6%). The mean additional time necessary for vaginal ovarian removal was 11.4 minutes. Although there was an increase in the mean change in hemoglobin (preoperative minus postoperative) associated with attempted vaginal oophorectomy (2.2 versus 1.9,P= 0.004), no statistically significant association was identified when change in hemoglobin was stratified for concurrent procedures or when successful and unsuccessful oophorectomy attempts were compared(P >0.05). No complications were related to attempted or successful vaginal oophorectomy. The inability to remove any ovary through the vagina occurred in 50 patients (10%). The most common reasons for the failure of vaginal oophorectomy included high position of the ovaries (76%), adhesions (11%), and ovarian disease (4%). Vaginal ovarian removal was less likely to be successful in older women who had higher degrees of pelvic relaxation and who were obese. Conclusions: In 90% of women on whom vaginal hysterectomy and oophorectomy were attempted, one or both ovaries could be removed vaginally without an increase in perioperative morbidity when compared with patients who underwent vaginal hysterectomy only.