Evaluation of the clinical value of uterine benign disease in perimenopausal women underwent simultaneous hysterectomy and bilateral salpingectomy / 中国综合临床

ABSTRACT

Objective To investigate the effects of uterine benign disease in perimenopausal women underwent simultaneous hysterectomy and bilateral salpingectomy on pelvic pseudocyst,ovarian function and symptoms of peri-menopausal period.Methods Nine hundred and ninety-three patients with benign uterine disease underwent hysterectomy of total or subtotal uterus were selected as our subjects,who hospitalized from Jan 2005 to Dec 2009.All patients were followed up for 36 months,and 235 patients were lost.The rest 758 patients included 438 patients underwent simultaneous hysterectomy and bilateral salpingectomy,who were served as study group,and 320 patients underwent only hysterectomy were served as control group.The occurrence of pelvic pseudocyst,symptoms of peri-menopausal period and the changes of serum sexual hormone were observed.Results (1) The rate of pelvic pseudocyst was 1.6％ (7/438) in study group,which was significantly lower than that in control group (4.4％ (14/320),x2 =10.962,P =0.026).(2) Follicle-stimulating hormone (FSH) in study group at 6 months and 12 months after surgery were (17.7 ±2.3) U/L and (26.8±5.1) U/L,higher than that in control group((12.3 ±2.9) U/L,(22.4 ± 3.2) U/L,t =-1.020,-1.162,P ＜ 0.05);FSH in study group(34.0 ± 6.8) U/L was lower than that in control group (39.1 ± 4.9) U/L at 36 months after surgery,and the difference was statistically significant (t =-1.209,P ＜ 0.05).At 3 months and 12 months after surgery,luteinizing hormone (LH) in study group were (14.0 ± 2.3) U/L and (26.2 ± 3.1) U/L,higher than that in control group ((11.7 ± 2.6) U/L,(21.6 ± 1.9) U/L; t =-1.421,-0.962,P ＜ 0.05).Estradiol in study group was (90 ± 23) pmol/L,lower than that in control group((110 ± 18) pmol/L) at 24 months after surgery(t =-1.502,P ＜0.05).(3) At 6 months after surgery,the rate of perimenopausl systems was 21.7％ (95/438) in study group,higher than that in control group (14.1％ (45/320),x2 =9.102,P =0.027).However,at 24 months after surgery,the rate of perimenopausal symptoms in control group was 60.6％ (194/320),higher than that in study group (47.0％ (206/438),x2 =7.620,P =0.039).Conclusion Simultaneous hysterectomy and bilateral salpingectomy could decrease the occurrence of pelvic pseudocyst and peri-menopausal symptoms nearly equivalent to that of hysterectomy only in patients with benign uterine diseases.