ABSTRACT
Objective:To study the influence of prophylactic bilateral salpingectomy during hysterectomy in ovarian function of the premenopausal women with benign uterine disease and its preventive effect on the pelvic diseases(malignant /benign pelvic lesions or pelvic inflammatory disease).Methods:A total of 100 patients with benign uterine disease underwent hysterectomy were collected and divided into two groups,including 50 patients underwent simultaneous hysterectomy and prophylactic bilateral salpingectomy (prevention group) and 50 patients underwent only hysterectomy (control group).The operative time,blood loss,evacuation time,and hospitalization time of the patients in two groups were detected;the antral follicle count,levels of serum estradiol(E2),follicle stimulating hormone(FSH) and luteinizing hormone(LH)) and the incidence of perimenopausal symptoms of the patients in two groups before operation and six months,1 year after operation were compared;the incidence of pelvic disease of the patients after operation were compared.Results:The operative time,blood loss,evacuation time,and hospitalization time of the patients between two groups were not significantly different(P>0.05).Compared with before operation,the antral follicle count and the E2 levels of the patients 6 months and 1 year after operation in two groups were decreased,and the FSH and LH levels of the patients were inc reased (P0.05).The incidence of perimenopausal symptoms of the patients in two groups 6 months and 1 year after operation showed no significant difference(P>0.05).The incidence of ovarian malignant tumor and ovarian benign tumor of the patients in two groups 6 months and 1 year after operation had no significantly differences (P>0.05).The incidence of pelvic inflammatory disease of the patients in control group was higher than that in prevention group(P<0.05).There were 2 patients diagnosed as tubal carcinoma in control group 1 year after operation,and the pathological findings showed the atypical cells in 2 patients in prevention group.Conclusion:Prophylactic bilateral salpingectomy during hysterectomy does not damage the ovarian function and can reduce the incidence of pelvic malignant/ benign tumor and pelvic inflammatory disease.
ABSTRACT
Objective The risk of ovarian/pelvic serous cancer can be reduced by prophylactic bilateral salpingectomy ( PBS) at the time of hysterectomy .This study was to evaluate the short-term influence of PBS plus hysterectomy on ovarian reserve in premenopausal women . Methods We retrospectively analyzed the clinical data about 60 premenopausal women treated by total lapa-roscopic hysterectomy ( TLH) for benign indications , 30 undergoing PBS at the same time ( the experimental group ) while the other 30 with the ovary preserved ( the control group ) .We compared the levels of FSH, LH, E2, and anti-Müllerian hormone ( AMH) and the inci-dence of peri-menopausal symptoms between the two groups of patients before and at 1 and 3 months after operation . Results Statistically significant differences were not observed between the two groups in the such baseline clinical characteristics as age , gravidity, parity, men-strual cycle, comorbidity, diagnosis, comorbidities, and history of abdominal surgery (P>0.05), nor in the AMH level at the baseline ([1.08±0.08] vs [1.04±0.10] ng/mL) or at 1 month ([0.86± 0.44] vs [0.81±0.48] ng/mL) or 3 months postoperatively ([0.84±0.94] vs [0.68±0.42] ng/mL) (F=0.247, P=0.746).Howev-er, the mean level of AMH was markedly reduced at 1 and 3 months after operation as compared with the baseline ( P0.05) .There were not any statistically significant differences in the levels FSH, LH, and E2 between the two groups before or at 1 and 3 months after surgery (P>0.05), nor in the incidence rates of peri-menopausal symptoms at 1 month (6.7%vs 3.3%, P>0.05) or 3 months postoperatively (10.0%vs 6.7%, P>0.05). Conclusion PBS at the time of total hysterectomy in premenopausal women does not affect ovarian reserve in the short term .The level of AMH has a higher sensitivity than those of FSH , LH and E2 in the assessment of postoperative ovarian function .
ABSTRACT
Ovarian cancer accounts for more deaths than any other cancers of the female reproductive tract .There are no ef-fective screening tests .Prophylactic bilateral salpingectomy ( PBS) in standard hysterectomy in premenopausal women with benign con-dition may be a strategy for preventing pelvic serous cancer .To evaluate this procedure , we review the advances of the effectiveness of PBS in reducing the risk of malignant or benign pelvic pathologies , surgical or perioperative complications as well as the effects of sal-pingectomy on ovarian function .