Clinical Study On Intrafascial Hysterectomy With Intact Ascending Uterine Artery

Objective To study the clinical value of intrafascial hysterectomy with intact ascending uterine artery.Method A total of 84 pre-menopausal women with benign uterine diseases who underwent hysterectomy were included in this study. They were divided randomisedly into 2 groups, 41 were performed intrafascial hysterectomy with intact ascending uterine artery (study group); 43 underwent intrafascial hysterectomy only as control . The variables of operation and postoperation were studied and compared , especially the ovarian function and sexuality .Rseults In the study group the mean operation time was 58±19 min , blood loss volume was 83±19ml, the control group correspondingly were 60±22 min and 91±23ml. The interval of operation to normal movement was 19±8hrs, while the control group was 21±1.1hrs. The postoperation exhausting time was 20±2.4hrs , control group were 23±3.1hrs.The level of FSH measured preoperation and 1, 6, 12month postoperation correspondingly were: 4.84±1.23 u/l, 6.33±1.04 u/l,5.34±2.12 u/l,6.89±2.54u/l, control group were: 5.05±1.56 u/l, 9.45±2.01 u/l, 9.79±3.41 u/l, 10.21±3.12 u/l. The level of LH measured preoperation and 1, 6, 12month postoperation correspondingly were: 12.45±2.1 u/l, 14.28±3.21 u/l, 13.65±2.19 u/l, 14.13±1.68 u/l, control group were: 11.79±1.9 u/l,13.49±3.87 u/l,12.75±1.90 u/l, 13.57±2.34 u/l respectivly. The level of E₂ measured preoperation and 1 , 6, 12month postoperation correspondingly were: 91.04±3.43pg/ml, 87.95±5.42 pg/ml, 85.04±5.64 pg/ml, 76.12±2.36 pg/ml, control group were: 89.78±3.21 pg/ml, 65.04±4.32 pg/ml, 50.23±3.47 pg/ml, 40.54±1.23 pg/ml.The ratio of perimenopausal signs was 2.6%,control group was 25%.The Sexual functioning of two group have been improved, a little part of the operated patients was observed with increased sexual activity. Few patients had symptoms of urinary and defecate. There were significantly differences in FSH and E2 of the two groups,Our results also demonstrated that there were no statistical differences between two groups comparing: the variable of operation and postoperation, urinary ,defecate,LH and pulsatility index (PI) of uterine artery detected by using color Doppler ultrasonography, the latter eventhough there was little decreased , without significant differences .Conclusions Intrafascial hysterectomy with intact uterine artery could be performed with facility, less complications and slight influences on ovarian function , which could improve the quality of life of the patients, the long-term clinical effects should be further followed and studied .