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Sterilization TubalSALSTERNCT03860805

SALpingectomy for STERilization (SALSTER)

A study testing Laparoscopic tubal ligation and Laparoscopic bilateral salpingectomy in people with Sterilization Tubal and Salpingectomy, run by Göteborg University at 1 site in Sweden.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The SALSTER study is a register-based randomized clinical trial (R-RCT) that examines if laparoscopic salpingectomy instead of tubal ligation, as a contraceptive method, has no increased risk for complications and has no negative impact on ovarian function. Read more about this study

Who is it for?
Ages 18 to 49 years, women onlyHealthy volunteers can take part
Conditions the study is for
Sterilization Tubal, Salpingectomy, Laparoscopy
What is being tested?
Laparoscopic tubal ligation and Laparoscopic bilateral salpingectomy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
900 participants
Where
1 siteSweden
Study dates
3 Apr 2019to 31 Dec 2050
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 49 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Planned laparoscopic sterilization
  • Willing to be randomized

Who cannot join

  • Women older than 49
  • Not understanding the oral or written study information
  • Previous malignancy involving radiation, chemotherapy or endocrine treatment affecting ovarian function

Trial locations and contacts

1 site in 1 country.

Sweden1 site
  • Sahlgrenska University Hospital

    Gothenburg, 413 45

Other trials in Sweden

About this study

Official title: SALpingectomy for STERilization (SALSTER); a Randomized Trial

The SALSTER study is a register-based randomized clinical trial (R-RCT) that examines if laparoscopic salpingectomy instead of tubal ligation, as a contraceptive method, has no increased risk for complications and has no negative impact on ovarian function.

Read the detailed description

SALSTER Study

In the last years, the management of Fallopian tubes in benign surgery has drawn a lot of attention due to rising evidence showing that some aggressive forms of ovarian cancer may originate from the distal Fallopian tubes. Concerns were raised about the implications of salpingectomy to surgical outcome and function of the ovaries. The SALSTER study attempts to evaluate the effect of salpingectomy, in regards to surgical outcomes and ovarian function, in women seeking permanent contraception with tubal ligation.

The SALSTER study is a register-based randomized clinical trial (R-RCT) that examines if laparoscopic salpingectomy instead of tubal ligation, as a contraceptive method, has no increased risk for complications and has no negative impact on ovarian function. Complications will be assessed primarily at eight weeks post-surgery according to the Clavien-Dindo classification and the existing complications questionnaires in the Swedish National Quality Register of Gynecological Surgery (GynOp). Ovarian function will be primarily assessed by determining the age of natural menopause, measured through questionnaires on bleeding pattern in GynOp every other year. Approximately 900 patients will be recruited.

In a subset of patients, the difference in Anti-Müllerian Hormone (AMH) levels from the time of surgery and 1-year after surgery will be compared between the groups. Approximately 180 patients will be recruited.

The study is expected to start in the beginning of 2019 and the first results are expected in 2021.

Being tested
Laparoscopic tubal ligation, Laparoscopic bilateral salpingectomy
Keywords
Sterilization Tubal, Salpingectomy, Laparoscopy, Ovarian Reserve

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Laparoscopic tubal ligationProcedure or surgery

    Laparoscopic tubal ligation

  • Laparoscopic bilateral salpingectomyProcedure or surgery

    Laparoscopic bilateral salpingectomy

Study groups in NCT03860805
Study groupRoleWhat they receive
Laparoscopic tubal ligationActive comparatorPatients who seek for surgical permanent contraception and randomized to laparoscopic tubal ligation
Receives: Procedure: Laparoscopic tubal ligation
Laparoscopic bilateral salpingectomyActive comparatorPatients who seek for surgical permanent contraception and randomized to laparoscopic bilateral salpingectomy
Receives: Procedure: Laparoscopic bilateral salpingectomy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Complications

    Complication according to the Clavien-Dindo classification or specific questions on complications in GynOp Register (Swedish National Quality Register of Gynecological Surgery). Binary data.

    Measured: Eight weeks post-operatively

  2. Age at menopause

    Determined from questionnaires on bleeding pattern in GynOp. Continuous data.

    Measured: Twenty years

Secondary outcomes (14)
  1. Severe complications

    Complications according to the Clavien-Dindo classification or the specific questions on complications in GynOp. Binary data.

    Measured: Eight weeks post-operatively

  2. Operative time

    In minutes. Continous data.

    Measured: At day of surgery

  3. Perioperative blood loss

    In millilitres. Continous data.

    Measured: At day of surgery

  4. Length of hospital stay

    In Days. Continous data.

    Measured: Assessment will be done at discharge from hospital after surgery, including a period up to 8 weeks

  5. Complications according to Clavien-Dindo

    Assessed according to Clavien-Dindo. Binary data.

    Measured: One year after surgery

  6. Complications

    Assessed according to the existing questions on complications in GynOp. Binary data.

    Measured: One year after surgery

  7. Age at the start of the perimenopausal state

    Assessed through questionnaires in GynOp. Continous data.

    Measured: Up to 55 years of age

  8. Length of the perimenopausal state

    Assessed in GynOp. Measured in days. Continous data.

    Measured: Up to 55 years of age

  9. Change in menopausal symptom score

    Assessed with Menopause Rating Scale (MRS) in GynOp. MRS is a validated scale consisting of 11 questions, each yields a score of 1-4. Total score is reported, ranging from 4 to 44, where 4 indicates no menopausal symptoms and 44 maximum symptoms. Ordered categorical data.

    Measured: Up to 55 years of age

  10. Use of hormone replacement therapy at any time during follow-up

    Either an answer yes to question in GynOp or prescription in The Drug Prescription Register will give information on the outcome (yes/no). Binary data.

    Measured: Up to 55 years of age

  11. Subsequent surgery on uterus, salpinges and/or ovaries. Binary data.

    Assessed through GynOp and through The Patient register. Both registers yield the same data (subsequent surgery yes/no). Binary data.

    Measured: At one year and up to 55 years of age

  12. Pregnancy

    Assessed in GynOp, whether pregnancy has occurred (yes/no). Binary data.

    Measured: At one year and up to 55 years of age

  13. Epithelial ovarian cancer including histopathological types and grade, primary tubal and peritoneal cancer, as well as clinical stage according to International Federation of Gynecology and Obstetrics (FIGO)

    Assessed through The Swedish Cancer Register, The Swedish Quality Register for Gynaecological Cancer, The Swedish Cause of Death Register and The Swedish Population Register. Time-to event data.

    Measured: 40 years

  14. Secondary expressions of estrogen deficiency

    Measures of fractures related to osteoporosis and cardio-vascular events will be assessed through the Patient register. Binary and time-to-event data.

    Measured: 40 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Mar 2019
  2. Study start3 Apr 2019
  3. Primary completionApr 2043 (estimated)
  4. Study completion31 Dec 2050 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
900 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03860805
Sponsor's protocol ID
316-18
Acronym
SALSTER
Status last verified
Jan 2025
First submitted
30 Oct 2018
Last updated
17 Jan 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Collins, E., Strandell, A., Granåsen, G., I. A. (2018). Increased risk of menopausal symptoms one year after opportunistic salpingectomy - A retrospective observational cohort study based on the Swedish National Quality Register of Gynecological Surgery. Paris: EBCOG. Retrieved from http://www.ebcog2018.org/content/detailed-program

  • Dilley SE, Havrilesky LJ, Bakkum-Gamez J, Cohn DE, Michael Straughn J Jr, Caughey AB, Rodriguez MI. Cost-effectiveness of opportunistic salpingectomy for ovarian cancer prevention. Gynecol Oncol. 2017 Aug;146(2):373-379. doi: 10.1016/j.ygyno.2017.05.034. Epub 2017 Jun 1.

    PubMed 28577884
  • Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004 Aug;240(2):205-13. doi: 10.1097/01.sla.0000133083.54934.ae.

    PubMed 15273542
  • Falconer H, Yin L, Gronberg H, Altman D. Ovarian cancer risk after salpingectomy: a nationwide population-based study. J Natl Cancer Inst. 2015 Jan 27;107(2):dju410. doi: 10.1093/jnci/dju410. Print 2015 Feb.

    PubMed 25628372
  • Ganer Herman H, Gluck O, Keidar R, Kerner R, Kovo M, Levran D, Bar J, Sagiv R. Ovarian reserve following cesarean section with salpingectomy vs tubal ligation: a randomized trial. Am J Obstet Gynecol. 2017 Oct;217(4):472.e1-472.e6. doi: 10.1016/j.ajog.2017.04.028. Epub 2017 Apr 25.

    PubMed 28455082
  • Heinemann K, Ruebig A, Potthoff P, Schneider HP, Strelow F, Heinemann LA, Do MT. The Menopause Rating Scale (MRS) scale: a methodological review. Health Qual Life Outcomes. 2004 Sep 2;2:45. doi: 10.1186/1477-7525-2-45.

    PubMed 15345062
  • Helden JV, Weiskirchen R. Age-independent anti-Mullerian hormone (AMH) standard deviation scores to estimate ovarian function. Eur J Obstet Gynecol Reprod Biol. 2017 Jun;213:64-70. doi: 10.1016/j.ejogrb.2017.04.029. Epub 2017 Apr 18.

    PubMed 28437631
  • Kotlyar A, Gingold J, Shue S, Falcone T. The Effect of Salpingectomy on Ovarian Function. J Minim Invasive Gynecol. 2017 May-Jun;24(4):563-578. doi: 10.1016/j.jmig.2017.02.014. Epub 2017 Feb 20.

    PubMed 28223181
  • Labidi-Galy SI, Papp E, Hallberg D, Niknafs N, Adleff V, Noe M, Bhattacharya R, Novak M, Jones S, Phallen J, Hruban CA, Hirsch MS, Lin DI, Schwartz L, Maire CL, Tille JC, Bowden M, Ayhan A, Wood LD, Scharpf RB, Kurman R, Wang TL, Shih IM, Karchin R, Drapkin R, Velculescu VE. High grade serous ovarian carcinomas originate in the fallopian tube. Nat Commun. 2017 Oct 23;8(1):1093. doi: 10.1038/s41467-017-00962-1.

    PubMed 29061967
  • McKinlay SM, Brambilla DJ, Posner JG. The normal menopause transition. Maturitas. 1992 Jan;14(2):103-15. doi: 10.1016/0378-5122(92)90003-m.

    PubMed 1565019
  • Shih IeM, Kurman RJ. Ovarian tumorigenesis: a proposed model based on morphological and molecular genetic analysis. Am J Pathol. 2004 May;164(5):1511-8. doi: 10.1016/s0002-9440(10)63708-x.

    PubMed 15111296
  • Shinar S, Blecher Y, Alpern S, Many A, Ashwal E, Amikam U, Cohen A. Total bilateral salpingectomy versus partial bilateral salpingectomy for permanent sterilization during cesarean delivery. Arch Gynecol Obstet. 2017 May;295(5):1185-1189. doi: 10.1007/s00404-017-4340-x. Epub 2017 Mar 11.

    PubMed 28285425
  • Tehrani FR, Mansournia MA, Solaymani-Dodaran M, Azizi F. Age-specific serum anti-Mullerian hormone levels: estimates from a large population-based sample. Climacteric. 2014 Oct;17(5):591-7. doi: 10.3109/13697137.2014.912262. Epub 2014 Jul 9.

    PubMed 24716733
  • Trabuco EC, Moorman PG, Algeciras-Schimnich A, Weaver AL, Cliby WA. Association of Ovary-Sparing Hysterectomy With Ovarian Reserve. Obstet Gynecol. 2016 May;127(5):819-827. doi: 10.1097/AOG.0000000000001398.

    PubMed 27054925
  • Wang Y, Mang M, Wang Y, Wang L, Klein R, Kong B, Zheng W. Tubal origin of ovarian endometriosis and clear cell and endometrioid carcinoma. Am J Cancer Res. 2015 Feb 15;5(3):869-79. eCollection 2015.

    PubMed 26045974

Questions about this trial

What is this clinical trial studying?

A study testing Laparoscopic tubal ligation and Laparoscopic bilateral salpingectomy in people with Sterilization Tubal and Salpingectomy, run by Göteborg University at 1 site in Sweden.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 17 Jan 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Complications (time frame: Eight weeks post-operatively). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03860805, which also lists 17 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Jan 2025.

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