Despite small but significant decreases in the incidence of hysterectomy in recent years,1 approximately 600 000 women undergo the procedure each year in the United States. After cesarean delivery, hysterectomy is the second most common surgery performed on women of child-bearing age.2 Because elective BSO reduces the risk of ovarian cancer,3 the procedure is performed in conjunction with more than half of all hysterectomies; incidence trends for the dual surgery vary by age, with higher proportions of older women undergoing concomitant BSO.2