The Influence On Ovarian Function Of The Treatment For The Patients With Uterine Myoma By Three Different Operative Methods

Objective:To explore the influence on ovarian function and sexual function of thetreatment for uterine leiomyoma by three operative methods.Methods:90women with uterine leiomyoma were recruited into the study randomly inour hospital from December2009to December2011,30cases experiencedmyomectomy （group A）, while30cases had been undergone total hysterectomy（group B）,and the remaining30cases had been undergone subtotal hysterectomy（group C）. The sexual hormone（E₂，FSH，LH） levels were detested respectively byElectrochemilumin-escence method preoperative, three months and six monthspostoperative，and sinus follicle count were measured through the vaginal ultrasound（AFC）. we graded the sexual function of patients by the female sexual function scale（FSFI） preoperative and6months postoperative. And we surveyed perimenopausalsymptoms1year postoperative which scored by a modified Kupperman rating scoremethod.Results:1. serum sex hormone3months and6months postoperative compared withpreoperative, E₂slightly decreased, FSH and LH slightly increased, but all thesedifferences were not statistically significant in group A（P>0.05）. In group B andgroup C, FSH and LH levels were increased at three months and six monthspostoperative. Significant difference was found between preoperative andpostoperative （P<0.05）. There is also a difference compared with group A in thesame period. And E₂levels decreased significantly compare with the preoperativeand the group A（P<0.05）. Compared3months and6months postoperative, thedifferences of FSH, LH and E₂were not statistically significant in group B and group C（P>0.05）.2. AFC we found the differences were not statistically significant betweenpreperative and postoperative in group A about AFC （P>0.05）. At3monthspostoperative, there was no statistical difference among three groups（P>0.05）.Compared with preoperative and postoperative of group A, the AFC level differencehad statistically significant in group B and group C at6months postoperative（P<0.05）. But there were not statistical difference between group B and group Cpostoperative.3. sexual function score In group A, all rates of sexual function inpostoperative is better than thatin preoperative（P <0.05）. But in group B, all ofthem were significantly lower than preoperative and postoperative in group A （P <0.05），except for sexual desire and sexual orgasm（P>0.05）. We found no statisticaldifference between preoperative and postoperative in group C, but lower than whichin postoperative of group A and better than which in postoperative of group B. Therewere no statistical difference between group B and group C （P>0.05）.4. Perimenopausal symptoms we found no significant difference inperimenopausal symptoms score between preoperative and postoperative in groupA（P>0.05）. Compared with themselves in preoperative postoperative in group A,there was statistically difference in group B and group C（P<0.05）. But there were nosignificant difference between group B and group C postoperative.5. The Correlation between sexual function score and sex hormone levelsSexual function scores were positively correlated with E₂（r=0.752, P<0.01）, andwere negatively correlated with FSH and LH（r=﹣0.852, P<0.01）.Conclusion:There was a certain negative influence on ovarian function experienced totalhysterectomy and subtotal hysterectomy, but the ovarian function have no obviousinfluence in such cases experienced uterine myomectomy; Myomectomy canimprove the sexual life quality, and sudtotal hysterectomy does not affect thepatients quality of life, while total hysterectomy reduce the patients sexual lifequality. Sexual function scores were positively correlated with E₂, and were negatively correlated with FSH and LH.