Impacts Of Panhysterectomy On The Morphous And Function Of Ovary And The Morphous Of Vagina

ObjectivesTo explore the effects of panhysterectomy on the blood supply,morphous and function of ovary;to analyze the relation of blood supply and function in ovary. Meanwhile,to explore the effects of hysterectomy on the morphous of vagina.The perfect operating modus could be selected according to the results of this study.MethodsSixty-two patiens(age 38～43 years old )with complete hysterectomy were study group.Forty patients(age 38～43 years old) without complete hysterectomy of control group were selected according to control principle.The blood flow rate(BFR), resistent index(RI),ovary volume,numbers of ovarian follicle,length and thickness of vagina were observed by color Doppler diasonography.FSH,E2 were determined by Electrochemiluminescence automatic determinator.The peri-menopausal period symptoms were surveyed through questionnaire.In study group,the above index were observed four times.The first time was before operation(the 5^th～7^th of menstrual cycle),and then,all index were detected at three months,one year and three years after operation respectively.In control group,all index were detected twice,include the 5^th～7^th of menstrual cycle and three years after it.Results(1) Blood flow rate.The PSV(cm/s) of study group were 19.21±2.82,12.45± 2.22,19.18±2.90,11.94±2.82 at four observation time point.The RI of study group were 0.53±0.04,0.53±0.04,0.52±0.04,0.61±0.05 respectively.It suggests that the blood flow rate decreased and resistance of blood flow increased after operation.There were no statistical difference between study group and control group PSV and RI of ovary before operation(P＞0.05).There were statistical difference between two groups PSV(study group 11.94±2.82 cm/s,control group 17.53±2.01cm/s) and RI(study group 0.61±0.05,control group 0.51±0.04) of ovary three years after operation(P=0.000).(2) E2.E2 declined after panhysterectomy.The results of E2 were 139.07±41.82 ng/L,91.39±34.62 ng/L,137.14±41.78 ng/L and 66.97±24.95 ng/L respectively. There were no statistical difference between study group and control group before operation.But there were statistical difference(t=8.41,P=0.000) between two groups E2(study group 66.97±24.95 ng/L,control group 121.89±36.36 ng/L) three years after operation.(3) PSV were positively correlated with E2(r=0.48),and it were negatively correlated with FSH(r=-0.33).(4) Numbers of ovarian follicle sudden dropped and ovary volume shrinked at three years after panhysterectomy.Length and thickness of vagina were decreased also.Compare to the length of vagina before operation,the decreased length were 1.2cm average after operation.(5) Peri-menopausal period symptoms.The proportion of these symptoms were significantly higher three years after operation in study group than control group.ConclusionsThe blood flow rate of ovary were significantly declined three years after panhysterectomy,it suggests that the function of endocrine system decreased. According to this result,hormone replacement therapy could be directed through a non-invasive method of evaluating ovary function by Transvaginal Ultrasound.The indicatio of panhysterectomy should be controlled strictly due to its many harmful effects on women.The operating modus could be selected according to length measuring of vagina.