Effects Of Total Abdominal Hysterectomy Research Articles

Effects of Total Abdominal Hysterectomy and Total Laparoscopic Hysterectomy on Urinary Tract Dysfunction.

Objectives:The aim of this study is to compare the urinary tract dysfunction rates of total abdominal hysterectomy (TAH) and total laparoscopic hysterectomy.Materials and Methods:Turkish patients who underwent TAH and laparoscopic hysterectomy were invited to participate in this study. In this study, 140 patients were examined who underwent hysterectomy in gynecology clinic between 2013 and 2018. The post residual urine volumes of patients were measured in the preoperative period and 8th week of the postoperative period as urodynamic evaluation (with office cystometry and Q tip test). Statistical analysis was performed using Kruskal–Wallis Mann–Whitney U test by using SPSS 22.0 statistical program.Results:No statistical significance (P > 0.05) was found between age, parity, menopause, and obesity in our patients who underwent TAH and laparoscopic hysterectomy with high postvoid residual values in the postoperative period.Conclusion:In this study, no statistical significance was found between the hysterectomy techniques on urinary tract dysfunction. It can be said that laparoscopy should be more preferable in correctly selected patients for minimal dysfunctional complications.

The Effects of Total Abdominal Hysterectomy on Ovarian Function – Serial Changes in Serum Anti-Müllerian Hormone, FSH and Estradiol Levels

The aim of this study was to evaluate ovarian function with longitudinal changes in serum levels of anti-mullerian hormone (AMH), follicle stimulating hormone (FSH) and estradiol (E2) after total abdominal hysterectomy (TAH) with ovarian conservation. In this prospective longitudinal study, atotal of 29women, aged 39 to 48years, suffering from uterine pathologies underwent TAH with ovarian conservation. Their serum AMH, FSH and E2 levels were measured at baseline, at the first month and the third month after TAH. There was astatistically significant decrease in AMH serum levels between the baseline and the first postoperative month; the values were 0.22 (0.16-1.49) ng/mL and 0.18 (0.04-0.52) ng/mL, respectively. However, significant differences were not seen for serum levels of FSH and E2 when baseline and one-month values were compared. In addition, no statistically significant differences were detected between the baseline and third-month serum AMH, FSH and E2 levels. The study demonstrated that TAH affects ovarian function temporarily.

The effect of total abdominal hysterectomy on serum anti-Müllerian hormone levels: a pilot study

ABSTRACTObjective To evaluate the effect of hysterectomy on levels of serum anti-Müllerian hormone (AMH), an indicator of ovarian reserve.Method Twenty-two premenopausal women between 40 and 50 years of age who underwent total abdominal hysterectomy for uterine leiomyoma were enrolled to the patient group and unaffected women in a similar age range constituted the control group. Samples were collected preoperatively and at the 4th month postoperatively from the patients and two times at 4 months apart from the controls. Serum AMH levels were detected with enzyme-linked immunosorbent assay and compared within each group and between groups.Results Baseline serum AMH values were similar (1.46 ± 2.02 ng/ml for the hysterectomy group and 1.53 ± 1.82 ng/ml for the control group, p = 0.73). Serum AMH levels at month 4 decreased to 0.62 ± 0.9 ng/ml and 1.26 ± 1.78 ng/ml for hysterectomy patients and controls, respectively (p = 0.001 and < 0.001, respectively). Although the percentage median decrease was higher in hysterectomized women (58.9% vs. 28.5%), this was statistically insignificant (p = 0.26).Conclusion Although not statistically significant, our study demonstrated that total abdominal hysterectomy causes 30% more loss of ovarian reserve in addition to the effects of aging. Further research on larger populations is needed to confirm our results and to apply them in clinical practice.

Clinical analysis of different hysterectomy approaches on 710 cases

Objective To compare the clinical effects of total abdominal hysterectomy(TAH), laparoscopic vaginal hysterectomy(LAVH) and transvaginal hysterectomy(TVH). Methods A retrespective analysis was conduc-ted in 710 women underwent different hysterectomy approaches,includlng 397 patients underdoing TAH,176 underdo-ing LAVH and 137 treated with TVH. Results Uterine volume, operative pelvis, pelvic adhesion were main factors infulencing different operative styles for hysterectomy ( P<0.05 ). Compared with TAH, LAVH, TVH, the operation time,blood loss ,operation complicafion and recovery time of intestinal function were significantly difference(P<0.05). Conclusion Uterine volume, pelvic adhesion, operative pelvis were major factors influencing different operative styles for hysterectomy. The clinical efficacy of TVH is best,which is less time, minimal invasion, shorter recovery time and lower cost. The application of LAVH provides a promising microinvasive approach for vaginal hysterectomy which can make operation easy, visual field clear and is worthy to be advocated too. Key words: Hysterectomy; Postoperative; Complications

Effect of Total Abdominal Hysterectomy on Ovarian Blood Supply in Women of Reproductive Age

The purpose of this study was to evaluate the effect of total abdominal hysterectomy on ovarian blood supply using transvaginal color Doppler ultrasonography in women of reproductive age. This prospective study included 61 women aged 40 years or younger who were divided into 2 groups: group 1, comprising 31 patients who underwent total abdominal hysterectomy (TAH); and group 2, comprising 30 women with no abnormalities. Inclusion criteria included normal ovarian function at baseline, with basal follicle-stimulating hormone levels of less than 15 mUI/mL, normal body weight, no tobacco use, and no history of laparotomy or ovarian disease. Ovarian arterial blood supply by determination of the pulsatility index (PI) on Doppler analysis and ovarian volume on transvaginal ultrasonography were assessed at baseline and at 6 and 12 postoperative months. The Student t test, profile analysis, and Friedman and Mann-Whitney tests were used in the statistical analysis of data. Statistical analysis of baseline data revealed that both groups were homogeneous. At months 6 and 12, greater ovarian volumes and lower PI values were observed in patients who underwent TAH (P < .05). By the end of the study, in 8 of the 31 patients who underwent TAH (25.5%), benign ovarian cysts were observed. In the control group, all the parameters studied remained unchanged. The reduced PI values observed on Doppler ultrasonography suggested a decrease in the resistance flow in the ovarian arteries in women of reproductive age who underwent TAH.

Sexual life following total abdominal hysterectomy

The goal of this study was to evaluate the effect of total abdominal hysterectomy (TAH) on sexual lives of patients in the postoperative period. Eighty-six patients who accepted to participate a phone-questionnaire were recruited in the study after TAH or TAH + BSO. They were asked about sexual desire, pain during sexual intercourse, frequency and satisfaction of sexual intercourse at pre- and postoperative periods, and loss of "feeling a woman" in the postoperative period. Sexual desire, pain during sexual intercourse, loss of "feeling a woman" questions were answered as "yes" or " no", number of weekly sexual intercourse was recorded, and satisfaction was graded as no = 0, mild = 1 and complete = 2 points. While sexual desire and frequency were found to be significantly lower (p=0.026 and p=0.01 respectively), no difference was noted in dyspareunia and satisfaction. When the patients were divided into two groups according to the presence of endogenous or exogenous estrogen, no difference was seen between the two groups in the postoperative period. We concluded that the effect of TAH or TAH+BSO operations were mainly on sexual desire and the number of weekly intercourse, and estrogen in the postoperative period did not make any difference between the two groups.

Effect of total abdominal hysterectomy on pelvic floor function.

Historically, hysterectomy is one of the oldest gynecologic operations, dating back to the 1840s. Currently, it is the most common gynecologic operation performed and is associated with marked improvement in the patients' quality of life. It is widely considered a safe procedure with an extremely low mortality rate (<0.1%). The majority of hysterectomies are done abdominally, with the vast majority being total abdominal hysterectomies. The effect of hysterectomy on pelvic floor function has been a subject of long debate. Various studies have reached different and rather contradictory results. Most of these studies lack stringent methodologic standards, being retrospective, observational, or uncontrolled. A recent excellent study assessed the effect of abdominal hysterectomy on pelvic floor function as 1 functional unit and concluded that both total and subtotal abdominal hysterectomies have no detrimental effect on the pelvic floor function up to 1 year postoperatively.

Perioperative changes in circulating leptin levels in women undergoing total abdominal hysterectomy.

To investigate the effects of total abdominal hysterectomy on circulating leptin levels, 16 pre- and 8 postmenopausal patients with uterine leiomyoma or carcinoma in situ of the uterine cervix were enrolled. Serum levels of leptin and fasting blood sugar (FBS) were determined before (day -7) and after surgery (day +1 and +7). Body mass index (BMI) was recorded at day -7 and +7. Anesthesia duration, surgical duration, hematology, and blood loss during surgery were recorded. Relations of these variables to serum leptin levels were investigated. Serum leptin levels rose from 7.3+/-4.7 ng/mL to 9.3+/-5.8 ng/mL at day +1 (P < 0.01), then decreased to 4.9+/-3.0 ng/mL at day +7 (P < 0.05 vs. values at day -7 and +1). FBS levels also rose from 89.4+/-7.5 mg/dL to 119.3+/-24.0 mg/dL (P < 0.01), then returned to normal at day +7 (96.2+/-9.0 mg/dL). However, there was no significant correlation observed between FBS and leptin levels at each time point (r < or = 0.22). BMI decreased from 22.7+/-3.0 kg/m2 to 21.7+/-2.9 kg/m2 at day +7 (P < 0.001). At day -7 and +7, leptin levels were positively correlatd with BMI (r = 0.79, P < 0.001 and r = 0.71, P < 0.001, respectively). Circulating leptin levels were increased on day one after total abdominal hysterectomy.