Effects of laparoscopic total vuersus subtotal hysterectomy on ovarian function and sexual life quality of patients with uterine myoma

Abstract

Objective To investigate the effects of laparoscopic total versus subtotal hysterectomy on ovarian function and sexual life quality of patients with uterine myoma (UM). Methods 84 patients with UM treated at our hospital from May, 2013 to July, 2016 were selected and divided into group A and group B, 42 for each group. Group A underwent laparoscopic subtotal hysterectomy and Group B underwent laparoscopic hysterectomy. All the patients were followed up 3 months. The general situation and postoperative recovery were compared between the two groups. The immune function [T lymphocyte subsets (CD3+, CD4+, CD4+/CD8+)] levels before and 72 h after operation, ovarian function indicators [estrogen (E2), follicle stimulating hormone (FSH), the number of antral follicles (AFC)] before and 3 months after operation, the scores of anxiety (HAMA), depression (HAMD), and sexual quality of life (FSFI) were compared between these two groups. Results The operation time, anal exhaustion time, and hospitalization time were shorter and the intraoperative bleeding volume was lower in group A than in group B, with statistical differences (all P 0.05); the levels of CD3+, CD4+, and CD4+/CD8+ were lower 72 h after than before operation in both groups and changed less in group A than in group B 72 h after operation, with statistical differences (all P<0.05). There were no statistical differences in the levels of E2 and FSH and AFC counting between these two group before operation; 3 months after operation, the level of E2 decreased, the level of FSH increased, and AFC counting lessened in both group and all the three changed less in group A than in group B, with statistical differences (all P<0.05). There were no statistical differences in the scores of HAMA, HAMD, and FSFI between these two group before operation; 3 months after operation, the scores of HAMA and HAMD were lower and the score of FSFI was higher in group A than in group B, with statistical differences (all P<0.05). Conclusions Laparoscopic hysterectomy has certain impact on patients’ ovarian function and immune function; but compared with laparoscopic total hysterectomy, laparoscopic subtotal hysterectomy has less impact, and the former is more conducive to ease the patients’ negative emotions and improve the sexual quality of life. Key words: Uterine fibroids; Hysterectomy; Subtotal hysterectomy; Ovarian function; Sexual quality of life