Abstract:

Objective To explore the effects of different patterns of hysterectomy and adnexectomy on reproductive hormones. Methods Sixty-five hospitalized patients aged from 40 to 45 years with benign gynecologic tumors and regular menstruation were divided into 3 groups according to different surgical procedures: group Ⅰ (n=22), subtotal hysterectomy; group Ⅱ (n=23), total hysterectomy; group Ⅲ (n=20), subtotal hysterectomy plus unilateral adnexectomy. The serum levels of follicle stimulating hormone(FSH), luteinizing hormone(LH), estradiol (E2) and prolactin (PRL) were detected 1 d before operation, and 1 week, 3 months and 1 year after operation. Results One week after operation, E2 levels of all groups were significantly lower than that of 1 d before operation (P<0.05). Then E2 levels increased gradually in all groups, and 1 year after operation, E2 levels in group Ⅰ and group Ⅱ were close to that of before operation, while E2 level in group Ⅲ was still significantly lower than that of before operation (P<0.05). The levels of FSH and LH of 3 months after operation were significantly higher than those of 1 d before operation and 1 week after operation in all groups (P<0.05). One year after operation, the levels of FSH and LH were significantly higher than those of before operation in all groups, and the levels of FSH and LH in group I and group II were significantly lower than those of 3 months after operation (P<0.05). One week after operation, the levels of PRL in all groups were significantly higher than those of before operation (P<0.05). Conclusion After hysterectomy with or without unilateral adnexectomy, the level of E2 may significantly decrease and that of PRL significantly increase in short term, which may recover gradually. The levels of FSH and LH may significantly increase 3 months after operation, and then decrease gradually. But in long term, the function of ovary can not recover to that of before operation, and the operations can cause premature ovarian failure. The tendency of ovarian failure is most significant after subtotal hysterectomy plus unilateral adnexectomy.

Key words: Total hysterectomy, Subtotal hysterectomy, Subtotal hysterectomy plus unilateral adnexectomy, reproductive hormones