Effect Of Hysterectomy Research Articles

Does hysterectomy in a premenopausal woman affect ovarian function?

Women undergoing a hysterectomy without oophorectomy in their premenopausal years would expect to benefit from continued secretion of oestrogens to protect them from the conditions and symptoms associated with the climacteric and postmenopause. However, there is conflicting evidence regarding the effect of premenopausal hysterectomy on ovarian function. Some research indicates an increase in incidence and severity of menopausal symptoms following removal of the uterus, despite the ovaries remaining in place; others have failed to find evidence of a decrease in ovarian endocrine secretion, implying that the ovaries are unaffected. This article reviews the conflicting evidence regarding the effect of hysterectomy on ovarian function as well as examining evidence for counter-current exchange between the ovarian and uterine blood supplies. An hypothesis is put forward to explain how removal of a woman's uterus may affect her ovarian function.

The late effect of hysterectomy with or without postoperative radiotherapy on bladder dysfunction in patients with uterine cancer

A serial urodynamic study was performed in 491 patients with uterine cancer following radical hysterectomy (RH) involving postoperative pelvic radiation (RH+RT) and extended hysterectomy (EH) for 10 years after these respective treatments. The following evidence is presented: (1) increased volume of residual urine and sensory impairment occurred 1–2 months after radical hysterectomy with or without radiation, but was rarely seen in the EH group: (2) increased residual urine volume in the RH group gradually subsided 1–3 years after the treatment, while the RH+RT treatment resulted in a slight reduction: (3) late maximum cytometric capacity in the EH and RH groups remained stable throughout the study, but the RH+RT group showed a lower capacity (P<0.05) than the EH group, except in one set of determinations. (4) a high incidence of low bladder compliance in the RH group at 1–2 months decreased thereafter, whereas in the RH+RT group bladder compliance remained poor (23%) up to 7–10 years after treatment. In the EH group low bladder compliance was rarely seen: (5) sensory impairment, urinary incontinence and difficulty on urination remained unimproved in many patients in the RH+RT group, while the incidence of subsequent urological operations in the EH group was lower (P<0.05) than in the RH+RT group. Based on these findings, EH appears to be more beneficial for the retention of normal bladder function and radical hysterectomy with postoperative radiation results in deterioration of bladder activity.

Women who Have Undergone a Tubal Sterilization have a Reduced Risk of Contracting Ovarian Cancer

US researchers followed a cohort of 77544 married female registered nurses 30-55 years old from 1976 to 1988 to determine biological risk factors of ovarian cancer. They found 260 cases of confirmed ovarian cancer. Women who had undergone tubal sterilization were at a significantly lower risk of developing ovarian cancer than those who had not (relative risk [RR] = 0.29). It even had a protective effect when the researchers controlled for age weight parity duration of oral contraceptive (OC) use smoking age at menarche age at menopause and hysterectomy status. When they compared women who had undergone tubal sterilization with women who used other contraceptives tubal sterilization still had a significantly reduced risk of ovarian cancer (RR = 0.3). The same investigators compared 11017 women who had had a hysterectomy with 96851 premenopausal and postmenopausal women who had not had a hysterectomy to examine the effect of hysterectomy on ovarian cancer. Women who had undergone a hysterectomy were significantly less likely to develop ovarian cancer than those who had not undergone hysterectomy (RR = 0.66). A significant inverse association between women who had had the hysterectomy 5-9 years before and ovarian cancer existed while women who had undergone a hysterectomy at least 15 years before had a nonsignificant decrease in risk of developing ovarian cancer indicating that the screening of ovaries for malignancy prior to hysterectomy did not introduce detection bias into hysterectomys effect on ovarian cancer development. These findings show that tubal sterilization and hysterectomy have a protective effect against ovarian cancer but more research is needed to identify biological mechanisms.

The effect of hysterectomy, transcervical resection of the endometrium and cholecystectomy on urinary symptoms: A subjective analysis

SummaryThe association between hysterectomy and the subsequent development of urinary symptoms is contentious. Evidence to support a link has been presented over the years (Smith et al., 1970; Parys et al., 1989), but others have shown either no connection or one that is purely coincidental (Jequier, 1976; Griffith-Jones et al., 1991). Many women date the onset of urinary symptoms to their hysterectomy.

Effects of hysterectomy on ovulation and related ovarian functions in regular estrous cycle rats

The number of ovulation was significantly higher in hysterectomized rats with regular estrous cycles than in sham-operated rats at the estrous stage 20–24 days after operations (13.2±0.33 vs. 11.8 ±0.41, P<0.05). This finding suggests that hysterectomy facilitates the follicular maturation in rats. To examine the mechanism of facilitation on follicular maturation in hysterectomized rats, plasma FSH level, ovarian estradiol-17 β (E 2) and ovarian aromatase activity were measured 20 days after hysterectomy. Hysterectomy had no effect on plasma FSH levels at any of the estrous stages. Ovarian E 2 level and aromatase activity (AA) were significantly increased by hysterectomy only at diestrus-2 stage of the estrous cycle (E 2; 3.76±0.49 vs 1.48±0.49 ng/g ovarian tissue, P<0.05, AA; 1.36±0.15 vs. 0.83±0.11 pmol/h.mg ovarian tissue, P<0.05), but ovarian testosterone level was not affected by the operation. These results support the hypothesis that in rats hysterectomy facilitites follicular maturation. This may be due to an increase in ovarian E 2 level at the diestrus-2 stage, caused by heightened ovarian aromatase activity.

MANAGEMENT OF THE SYMPTOMATIC FIBROID IN WOMEN OLDER THAN 40 YEARS OF AGE: Hysterectomy or Myomectomy?

Although complications resulting from a myomectomy are infrequent, the overall risk is probably greater than a hysterectomy. The effect of hysterectomy on the specific women is difficult to quantify, however. Supracervical hysterectomy is a reasonable alternative in the woman with a normal cervix. Moreover, repeated laparotomies are not particularly advisable. In a woman who has previously undergone a myomectomy and has had a recurrent symptomatic myomatous uterus, the decision must be made either to proceed with a repeat myomectomy or to perform a hysterectomy. The chance of successfully achieving a pregnancy after a second myomectomy may be less favorable than after a primary myomectomy. A myomectomy can be a difficult and often time-consuming procedure. With meticulous attention to technique, however, the procedure can be accomplished safely and effectively with relatively ensured hemostasis and minimal blood loss. A myomectomy affords the option of preserving the uterus in those patients with symptomatic uterine myomata who desire to preserve their reproductive organs. However, careful assessment with meticulous counseling of the patient is essential. The potential option for a hysterectomy must always be preserved. Hysteroscopic resection of submucous myomata with endometrial ablation has become the technique of preference in many cases. At the moment, abdominal myomectomy is the preferred technique for the removal of intramural and subserosal myomata. For the present, laparoscopic myomectomy must be viewed as being of very limited acceptability.

Follow-up of Ovarian Endocrine Function in Premenopausal Women After Hysterectomy by Daily Measurements of Salivary Progesterone

Objective The effect of hysterectomy on ovarian endocrine function of premenopausal women was studied. Design The patients collected daily salivary samples during one preoperative cycle (1), the cycle of operation (2), the subsequent period of 30 days (3) and the cycle 6 months after operation (4). Patients Forty-one premenopausal women (aged 33-48 years) undergoing hysterectomy were studied; their preoperative cycles served as controls. The patients were also compared with a reference group of 17 younger fertile women. Measurements Salivary progesterone levels were measured by radioimmunoassay. Results Cycle 1 was more frequently short (P less than 0.01), with short luteal phase (P less than 0.01) and low progesterone secretion (P less than 0.05), than the cycles of younger women. Cycle 2 was longer than the other cycles (P less than 0.01), due to prolonged follicular phase (P less than 0.01). Cycle 3 differed from cycle 1 by the lesser frequency of short cycles (P less than 0.01). Cycle 4 and its follicular phase were longer than those measured in cycle 1 (P less than 0.05). Of the women with normal cycle 1, 39% (P less than 0.01) presented with luteal insufficiency (LPD, low luteal progesterone secretion) or anovulation (8%) in at least one of cycles 2 to 4. The frequency of LPD or anovulation was significantly higher in cycle 3 (P less than 0.05) but not in cycle 4, compared to 1. Conclusions Acute luteal progesterone deficiency after hysterectomy in premenopausal women is common but in most cases reversible.

Men's views about hysterectomies and women who have them.

Men's (N = 25) views about the effects of hysterectomy on women and on their relationships with women they knew who had experienced hysterectomies were solicited by interviews. Many men were not knowledgeable about hysterectomy. They perceived negative psychological, social and sexual effects of hysterectomy on women; but they did not think hysterectomy affected their relationships with women. However, they also communicate very little with women or health care professionals about hysterectomy.

Effect of hysterectomy on anorectal and urethrovesical physiology.

To investigate whether vaginal or total abdominal hysterectomy is associated with changes in anorectal and urethrovesical physiology, 26 women were studied before operation and six weeks and six months afterwards. The results showed a postoperative increase in both rectal and vesical sensitivity (p less than 0.01). Similar results were observed irrespective of the type of hysterectomy. No significant changes in rectal or bladder compliance were noted, and anal pressure and urethral pressure and length were unchanged after surgery. Whole gut transit was not affected by hysterectomy. Urinary symptoms occurred de novo in 6/26 women and gastrointestinal symptoms in 2/26 women. These results show that significant changes in rectal and vesical sensitivity occur after hysterectomy for benign disease. These persist for at least six months postoperatively but are not always associated with development of urinary or gastrointestinal symptoms.

Effects of hysterectomy on bowel and bladder function

A case control study compared the bowel habit of 91 post-hysterectomy women with paired controls from the same family doctor practice. More cases had an abnormal bowel frequency, a firmer stool consistency and assessed themselves as having abnormal bowel function, predominantly constipation after hysterectomy, than controls. Significantly more cases than controls had consulted a doctor because of constipation but there was no significant difference in laxative usage. There was a significant short-term association between decreased bowel frequency and increased urinary frequency after hysterectomy. This became highly significant in those patients who developed chronic symptoms. Oophorectomy, unilateral or bilateral, did not significantly affect bowel habit other than to intensify the change in stool consistency. The hypothesis is discussed that the post-hysterectomy effects on bowel and bladder function may have a common aetiology in a degree of autonomic denervation of both viscera.

Effects of Hysterectomy and Uterine Decidualization on in Vivo Levels of Prostaglandins in the Corpus Luteum of Adult Pseudopregnant Rats1

A possible role of the uterus in regulating content of luteal prostaglandins (PGs) was investigated. Pseudopregnancy was induced in adult virgin female rats by mating them with vasectomized male rats. On Day 5 of pseudopregnancy, decidualization of the uterus was induced or hysterectomy was performed. As controls, intact pseudopregnant animals with a luteal phase of 13 +/- 1 days were used. Measurements of in vivo tissue levels of PGF2 alpha, PGE2, and 6-keto-PGF1 alpha were performed by RIA after homogenization and extraction procedures in CL of pseudopregnancy and remainder of ovaries on Days 5, 13, and 19. Serum levels of progesterone and 20 alpha-dihydroprogesterone were determined by RIA. In hysterectomized animals, PGF2 alpha levels increased 2.5-fold in corpora lutea on Day 13 compared with levels on Day 5 of pseudopregnancy, but were still lower than in control rats undergoing functional luteolysis on Day 13. Decidual-tissue-bearing rats exhibited low levels of PGF2 alpha on Day 13 of pseudopregnancy. On Day 19, when luteolysis had occurred in decidual-tissue-bearing and hysterectomized rats, as judged by plasma levels of progestins, luteal content of PGF2 alpha was elevated to a similar level as that in control animals undergoing functional luteolysis on Day 13. When data pooled from control, decidual-tissue-bearing and hysterectomized rats were analyzed, a highly significant inverse correlation (r = -0.72, n = 46, p less than 0.001) between luteal PGF2 alpha content and ratio of plasma progestins was found.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of hysterectomy and semi-starvation on amino-acid gradients across liver, muscle and gut in rats

To study the effects of surgical stress and insufficient food intake on amino-acid exchange of liver, gut, and muscle, blood was sampled in random sequence from the aorta, the inferior caval vein, the portal vein, and the hepatic veins in 3 groups of 20 rats each. Control rats were fed ad libitum, hysterectomised rats were studied on the first and third post-operative day, and semi-starved rats were pair-fed to hysterectomised rats to an intake of 13% of control on the first day. Both groups lost 5–8% of body weight. Surgery increased the concentration gradient (release) of urea across liver by 60%, the glucose gradient (release) by 35%, and doubled the concentration gradients (uptake) across liver of alanine, arginine, glycine, lysine, proline, serine, and threonine, and decreased their plasma concentrations. There was no major change in hepatic amino-acid gradients in semi-starved animals, and there was no appreciable change in gradients of single amino-acids across gut or muscle in animals subjected to surgery or semi-starvation. Post-surgical increases in urea synthesis and hepatic uptake of uragenic and gluconeogenic amino-acids are due to the surgical stress and not to the post-operative semi-starvation.

The effect of hysterectomy and bilateral oophorectomy in women with severe premenstrual syndrome

The etiology of premenstrual syndrome is unknown, although this syndrome is linked to the menstrual cycle. Fourteen women with severe, debilitating premenstrual syndrome volunteered for a study of therapy by hysterectomy, oophorectomy, and continuous estrogen replacement. All had completed their families and had failed to benefit from previous medical treatment. The diagnosis and severity of premenstrual syndrome were assessed by means of prospective charting and psychological evaluation. All patients had clearly cyclic symptoms and psychological scores consistent with a major disruption of their lives before surgery. Six months after surgery, premenstrual syndrome symptom charting revealed complete disappearance of a cyclic pattern with scores equivalent to those of a normal population. Psychological measures 6 months after operation showed dramatic improvement in mood, general affect, well-being, life satisfaction, and overall quality of life. Surgical therapy, involving oophorectomy, hysterectomy, and continuous estrogen replacement, is effective in relieving the symptoms of premenstrual syndrome and is indicated for a small, selected group of women. (AM J OBSTET GYNECOL 1990;162:105-9.)

The effect of hysterectomy and bilateral oophorectomy in women with severe premenstrual syndrome

The etiology of premenstrual syndrome is unknown, although this syndrome is linked to the menstrual cycle. Fourteen women with severe, debilitating premenstrual syndrome volunteered for a study of therapy by hysterectomy, oophorectomy, and continuous estrogen replacement. All had completed their families and had failed to benefit from previous medical treatment. The diagnosis and severity of premenstrual syndrome were assessed by means of prospective charting and psychological evaluation. All patients had clearly cyclic symptoms and psychological scores consistent with a major disruption of their lives before surgery. Six months after surgery, premenstrual syndrome symptom charting revealed complete disappearance of a cyclic pattern with scores equivalent to those of a normal population. Psychological measures 6 months after operation showed dramatic improvement in mood, general affect, well-being, life satisfaction, and overall quality of life. Surgical therapy, involving oophorectomy, hysterectomy, and continuous estrogen replacement, is effective in relieving the symptoms of premenstrual syndrome and is indicated for a small, selected group of women.

Effect of hysterectomy on bowel function.

Effect of hysterectomy on bowel function.

Effect of hysterectomy on bowel function.

Effect of hysterectomy on bowel function.

Effect of hysterectomy on bowel function

Effect of hysterectomy on bowel function

Effect of hysterectomy on bowel function: Authors' reply

Effect of hysterectomy on bowel function: Authors' reply

Effect of hysterectomy on bowel function.

La constipation est frequente apres hysterectomie. Les troubles fonctionnels urinaires sont moins connus et moins frequents. La cause serait la meme: lesion de l'innervation neurovegetative du rectum et de la vessie

Effect of hysterectomy on the short life-cycle corpus luteum produced after GnRH-induced ovulation in the anoestrous ewe

Anoestrous Romney Marsh ewes were treated with small-dose (250 ng) multiple injections of GnRH. Ewes in Groups 1 and 3 were hysterectomized 2 weeks before treatment, while those in Groups 2 and 4 were intact controls. Groups 1 and 2 were primed with progesterone (+P) and treated with 2 h injections of GnRH (250 ng) for 36 h, while Groups 3 and 4 were not pretreated (-P) but were given 2 h injections of GnRH (250 ng) for 18 h. Both treatment regimens were terminated with a bolus injection of GnRH (125 micrograms), given to synchronize the timing of the LH surge and subsequent luteal progesterone production. The plasma progesterone profiles of 5/5 animals in Group 2 (+P controls) and 2/5 animals in Group 4 (-P controls) were indicative of normal luteal function, while the remaining 3/5 animals in Group 4 produced plasma progesterone profiles typical of abnormal luteal function. However, in all the hysterectomized animals (Groups 1 and 3) peripheral plasma progesterone concentrations rose to reach a mean peak value of 1.3 ng/ml plasma on Day 8 which was maintained in all animals irrespective of progesterone pretreatment. The absence of a fall in progesterone concentrations precluded the identification of any animal in Group 4 showing abnormal luteal function. It was also noted that, after hysterectomy, although the corpus luteum was maintained, it was with reduced secretory capacity. The prevention of the expected proportion (70%) of -P animals from displaying a decline in plasma progesterone concentration after hysterectomy provides firm evidence that the uterus is involved in the premature regression of the short-cycle corpus luteum.