Clinical research of effects of retaining the uterine blood supply hysterectomy on ovarian function

Yufei Cai,Hongxia Sun,J.Q Cheng,J Zhang,I Kim,Z.T Chi,H.L Moffitt

doi:10.1051/bioconf/20170801038

Abstract

Objective To evaluate the effect of hysterectomy for reserving the uterine blood supply on ovarian endocrine function and on symptoms of menopausal transition. Methods Uterine benign lesions should be line the uterus times total resection in 100 patients were randomly divided into hysterectomy group of retaining uterus vascular supply group(research group,n = 50) and traditional total hysterectomy group (the control group, n = 50), comparing two groups in operation time, intraoperative bleeding ,postoperative fever and residual polyp, blood tests were taken to check the serum sex hormone levels change and clinical observation for perimenopausal symptoms before and postoperative three months, six months, one year and two years at the same time respectively. Results There was no significant difference between two groups in operation time, intraoperative blood loss, postoperative fever and residual polyp (P 0.05),the symptoms of the menopausal transition hardly appear; postoperative FSH, LH increased significantly in control group (P<0.05),E2 decrease (P<0.05), perimenopausal symptoms appeared more often. Conclusion The effect of uterus hysterectomy for retaining vascular supply on ovarian endocrine function is less than the traditional total hysterectomy, this operation has a certain importance to preserve ovarian function and delay the occurrence of premature ovarian aging.

Highlights

The endocrine function of ovary can be affected by hysterectomy
In traditional hysterectomy, cutting off the ovarian branch of uterine blood vessels could reduce the ovarian blood supply by fifty to seventy percent, leading to ovarian follicle degeneration to reduce hormone production and ovarian function declined four to five years after hysterectomy,which increased the occurrence of complications such as peri-menopausal symptoms, osteoporosis, high blood lipids and coronary heart disease and so on
Subtotal hysterectomy for maintaining uterine vessels (STHMUV) is a kind of surgery that does not affect ovarian hormone secretion, which can ensure the blood supply to the ovaries after removal of uterus, STHMUV can delay the natural aging of the ovary

Summary

Methods

Uterine benign lesions should be line the uterus times total resection in 100 patients were randomly divided into hysterectomy group of retaining uterus vascular supply group(research group,n=50) and traditional total hysterectomy group (the control group, n=50), comparing two groups in operation time, intraoperative bleeding ,postoperative fever and residual polyp, blood tests were taken to check the serum sex hormone levels change and clinical observation for perimenopausal symptoms before and postoperative three months, six months, one year and two years at the same time respectively. There was no significant difference in age, types of diseases in the two groups (P>0.05).Cervix was examined and serum lipid levels were detected before operation. The control group with reference to Li Guangyi, editor in chief of "Practical Gynecology laparoscopic surgery" for the traditional subtotal hysterectomy [10]. The study group adopted the reservation of the uterine vessels subtotal hysterectomy. Standard deviation ( x ±s), single factor analysis of variance was used for comparison among groups, LSD-t test was used for comparison between two groups, the difference was statistically significant when P

Results

Discussion

Conclusion