[Evaluation of the clinical value of simultaneous hysterectomy and bilateral salpingectomy in perimenopausal women].

OBJECTIVE

To investigate the effects on pelvic pseudocyst, ovarian function and symptoms of peri-menopausal period in patients with benign uterine disease undergoing simultaneous hysterectomy and bilateral salpingectomy.

METHODS

From Jan. 2000 to Dec. 2006, 1193 patients with benign uterine disease underwent total or subtotal hysterectomy, they were followed up for 48 months, 334 patients lost follow-up, the other 859 patients were divided into 2 groups, including 348 patients undergoing simultaneous hysterectomy and bilateral salpingectomy in study group and 511 patients undergoing only hysterectomy in control group. The occurrence of pelvic pseudocyst and symptoms of peri-menopausal period and the changes of serum sexual hormone were observed.

RESULTS

(1) The rate of pelvic pseudocyst was 1.7% (6/348) in study group, which was significantly lower than 4.3% (22/511) in control group (P = 0.036). (2) There was an increasing trend of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and a decreasing trend of estradiol (E(2)) at range of 6 - 48 months after surgery. At 3 months after surgery, LH in study group was significantly higher than that in control group [(13.9 ± 2.2) U/L vs. (12.6 ± 2.5) U/L, P = 0.032]; FSH in study group at 6 months and 12 months after surgery were (17.6 ± 2.2) U/L and (26.7 ± 5.0) U/L, which were significantly higher than (16.2 ± 2.8) U/L and (24.3 ± 3.1) U/L in control group (P = 0.035 and P = 0.031). At 12 months after surgery, LH in study group of (24.1 ± 3.0) U/L was significantly higher than (22.5 ± 1.8) U/L in control group (P = 0.017). E(2) in control group of (97 ± 22) pmol/L was significantly lower than (109 ± 17) pmol/L in control group at 24 months after surgery (P = 0.028); FSH in study group was lower than that in control group at 48 months after surgery [(34.9 ± 6.7) U/L vs. (38.0 ± 4.8) U/L, P = 0.043]. There were no significant differences of FSH, LH, and E(2) between two groups at the other time points (P > 0.05). (3) At 6 months after surgery, the rate of perimenopausl systems of 21.8% (76/348) in study group was significantly higher than 15.9% (81/511) in control group (P = 0.026). However, at 24 months after surgery, the rate of perimenopausal symptoms of 54.4% (278/511) in control group was significantly higher than 47.1% (164/348) in study group (P = 0.036).

CONCLUSION

Simultaneous hysterectomy and bilateral salpingectomy could decrease the occurrence of pelvic pseudocyst, and had similar effects on ovarian function and peri-menopausal symptoms compared with only hysterectomy in patients with benign uterine diseases.