The Effect Of Total Hysterectomy And Hysterosalpingectomy On Ovarian Function In Patients

Objectives:This study was to explore the changes of sex hormone,antral follicle count,perimenopausal symptoms and so on,before and after hysterectomy and hysterosalpingectomy,in order to know the impact of hysterectomy and hysterosalpingectomy on ovarian reserve function,to provide the surgical approach and improve he quality of life of patients.Methods:This study included 80 patients(age 46.64±1.31 years)with benign uterine diseases,of which 40 patients undergo hysterectomy without bilateral salpingectomy,and 40 patients undergo hysterectomy with bilateral salpingectomy.Authors used the estradiol(E2),luteinizing hormone(LH),follicle stimulating hormone(FSH),antral follicle count(AFC),anti-Mullerian hormone(AMH)to assess the ovarian reserve function by Chemiluminescence analysis before surgery,after three and six months.modified Kupperman score was used to jugde whether the hysterectomy with or without bilateral salpingectomy influence on perimenopausal symptoms.Results:1.Ovarian reserve function of the two groups all changed significantly after surgery.(1)Sex hormone levels: Compared with preoperative,the levels of FSH and LH were significantly increased,and the levels of E2 and AMH were significantly decreased after 3 and 6months(P <0.05).Compared with 3 months after surgery,the levels of FSH and LH were slightly decreased,and the levels of E2 and AMH were slightly increased after 6 months.but there was no significant difference(P> 0.05).(2)Antral follicle count(AFC): After 3 and 6 months,AFC of the two groups were all lower than the preoperative(p <0.05).Both 3 months and 6 months after surgery,the AFC was similar(P> 0.05).2.After 3 months and 6 months,the levels of FSH and LH of group A were significantly lower than group B,but the levels of E2 and AMH were significantly increased(P <0.05).The AFC of group A was higher than group B(p <0.05).3.After surgery,all patients of two groups had different degrees of perimenopausal symptoms,and the symptoms of hot flashes,sweating,insomnia,irritability,dizziness,fatigue,weakness,muscle and joint pain and sexual life-changing accounted for a high proportion(more than 20%).Perimenopausal symptoms of group A was significantly lower than group B,and the difference was statistically significant(P <0.05).Conclusion:1.After 3 and 6 months,patients that undergo hysterectomy with and without bilateral salpingectomy the ovarian reserve function all decreased significantly.But after 6 months,the ovarian reserve function had been restored.2.Hysterectomy with bilateral salpingectomy more significantly impacted on the ovarian reserve function than hysterectomy without bilateral salpingectomy.3.Patients who undergo the hysterectomy with and without bilateral salpingectomy would appear perimenopausal symptoms after 3 to 6 months.