Effects Of Hysterectomy With Reservation Of Ascending Branch Of Uterine Artery On Ovarian Reserve Function

Objective: To study the clinical significance of hysterectomy with reservation of the ascending branch of uterine artery through serum biochemistry combined with ovarian hemodynamics to monitor ovarian reserve function and compared with traditional subtotal hysterectomy.Methods: The female patients who were initially diagnosed with uterine fibroids and surgical indications and agreed to undergo hysterectomy treatment from July 2018 to December 2019 in our hospital were selected as the study object.The patients who met the inclusion criteria were preoperatively checked and perform supracevical hysterectomy with reservation of the ascending branch of the uterine artery(study group n=30,age 43.56±3.51 years old)and traditional subtotal hysterectomy(control group n=30,age 43.93±3.77 years old),the follow-up time was determined according to the patient's original menstrual cycle,and follow-up visits were conducted respectively on the first 3-5 days in the first primary menstrual period(or early vaginal follicles suggested by transvaginal ultrasound)and the first 3-5 days in the third original menstrual period after surgery(or early vaginal follicles suggested by transvaginal ultrasound).The monitoring of serum biochemical indicators AMH,FSH,LH,and transvaginal color Doppler ultrasound detection of PSV and RI of bilateral ovarian interstitial arteries were included in preoperative examination and postoperative follow-up.SPSS 22.0 software was used for statistical analysis of the data to compare the effects of two subtotal hysterectomies on ovarian reserve function.Results: 1.There were no statistically significant differences in age,intraoperative blood loss and operative time between the two groups(P>0.05).2.Analysis of serum biochemical indicators: there were no significant differences in preoperative AMH,FSH and LH between the two groups(P>0.05).The AMH in the control group showed a downward trend,and the AMH value in the study group at the same postoperative time point was higher than that in the control group.There were statistically significant differences at different time points,between two groups and in the interaction of groups and time points(P<0.05).FSH in the control group showed an increasing trend,the FSH value in the study group was lower than that in the control group at the same postoperative time point,the differences between the two groups were statistically significant(P<0.05),and there were no significant differences at different time points and in the interaction of groups and time points(P > 0.05).At the same postoperative time point,the LH value of the study group was lower than that of the control group,and there were statistically significant differences between the two groups and in the interaction of the groups and time points(P<0.05),while there were no statistically significant differences at different time points(P > 0.05).3.Analysis of ovarian hemodynamic indicators: there were no statistically significant differences in preoperative PSV and RI between the two groups(P > 0.05).PSV showed a downward trend in the control group,and the PSV value in the study group was higher than that in the control group at the same postoperative time point,and there were statistically significant differences at different time points,between two groups and in the interaction of groups and time points(P<0.05);The RI value of the study group at the same time point was lower than that of the control group,there were statistically significant differences between the two groups and at different time points(P<0.05),and there were no significant differences in the interaction of groups and time points(P > 0.05).4.There were no statistically significant differences between the two groups in fever,urinary retention after catheter removal,or first-grade wound healing within 48 hours after surgery(P > 0.05).Conclusion: Compared with traditional subtotal hysterectomy,hysterectomy with reservation of the ascending branch of the uterine artery has no obvious damaging effects on ovarian reserve function during the study period.This operation can not only remove the lesion but also maintain the original state of ovarian reserve.And the blood supply environment,the difficulty of surgery and the recent postoperative complications have not increased.For women without menopause and with no fertility requirements,it is a surgical option that can guarantee the quality of postoperative life and is worthy of clinical promotion.