Analysis of the Battey Operation: Indications, Outcomes and Chronic Pelvic Pain
CANSAGE ePoster Library. Jarrell J. 09/27/19; 281624; eP-144
John Jarrell
John Jarrell
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Abstract
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Objectives: In 1872 Dr. Robert Battey removed the normal ovaries from a 30 year old woman theorizing menopause would reduce her severe pelvic pain. The normal ovariotomy (or Battey operation) was received enthusiastically initially but subsequently it fell out of favour from his peers. Recent criticism has been severe on the basis of poor indications such as hystero-epilepsy and ovaralgia. The object of this study was to explore the indications and outcomes of the operation. Study Methods: Scopus searches were reviewed for sources describing the reported indications. Battey’s report of the International Medical Congress in 1881, summarized the outcomes of 51 identified surgeons and 216 normal ovariotomies. Pain indications were identified by “hystero-epilepsy”, “ovaralgia” and “dysmenorrhea”; bleeding indications by “myomas” and “menorrhagia”. Results: Surgery for pain (N=133) was more frequent than surgery for bleeding (N=57). Surgery for pain had a lower mortality (11.3%) than surgery for bleeding (29.8%). The term “hystero-epilepsy” appears to describe the acute on chronic viscero-somatic pain referral in detailed cases reports. Conclusions: This study was intended to give a broader understanding of the “normal ovariotomy”. It was not intended to reject the previous criticisms that were focused on the removal of normal ovaries, ill-defined indications, menopausal complaints and mortality rates. This study does indicate the indications were mainly relevant to the time, suggests treatment was helpful in many instances, but warns us today about indication creep and poorly defined surgical indications.
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