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Cosmos Study
Preference for Salpingectomies over Tubal Ligations Among Female Sterilization Procedures Is Increasing
June 16, 2025
Kersten Bartelt, RN | Caleb Cox
Key Findings
Salpingectomieswere more than twice as common as tubal ligations in 2024. The ratio of salpingectomies increased from 1.2 in 2015 to 3.3 in 2024, demonstrating a change of practice in female sterilization.
Female sterilization procedures, including tubal ligations and salpingectomies (surgical removal of the fallopian tubes), have long been a primary method of permanent contraception. In recent years, medical evidence has highlighted the benefits of salpingectomy over tubal ligation, including potential reduction in ovarian cancer risk, leading to a reevaluation of clinical practices and patient preferences.1
We studied 509,895 patients who had a sterilization procedure performed between 2015 and 2024 to better understand the evolving dynamics of tubal ligations and salpingectomies. We found that the salpingectomy-to-tubal ligation ratio rose from 1.2 in 2015 to 3.3 in 2024. Notably, the accelerated trend after 2019 coincides with the publication from The American College of Obstetricians and Gynecologists that demonstrated the protective benefits of salpingectomy against ovarian cancer.
Figure 1
Salpingectomy to Tubal Ligation Ratio
Figure 1. The ratio of salpingectomies to tubal ligations performed. A ratio of 1 indicates that both procedures were performed with the same frequency. A ratio greater than 1 indicates that salpingectomies were performed more frequently than tubal ligations. For example, a ratio of 3.3 indicates that there were 33 salpingectomies performed for every 10 tubal ligations.
These data come from Cosmos, a dataset created in collaboration with a community of Epic health systems representing more than 294 million patient records from 1,600 hospitals and more than 37,000 clinics from all 50 states, Lebanon, and Saudi Arabia. This study was completed by two teams that worked independently, each composed of a clinician and research scientists. The two teams came to similar conclusions. Graphics by Brian Olson.
Patients who had a tubal ligation or salpingectomy during the study period in a department with fully useable data in Cosmos since before the start of the study period.
Tubal ligation
A procedure with either
CPT code 58670, 58671, or 58611
Procedure name containing “Tubal Ligation” not preceded by the word “without”
Procedures that occurred on the same encounter as a salpingectomy or that also met the salpingectomy criteriawere excluded.
Salpingectomy
A procedure with either
CPT code 58661 or 58700
Procedure name containing “Salpingectomy” not preceded by the word “without”
Procedures that occurred on the same encounter as a tubal ligation or that also met the tubal ligation criteria were excluded.
Department with fully useable data in Cosmos
The first month with 25% or more of the department’s monthly non-zero encounters sent to Cosmos
