[Influence of different operation modes in treatment of leiomyoma on reproductive endocrine hormone levels]

Abstract

Objective: To explore the most reasonable operation mode for treatment of leiomyoma so as to protect the ovary function of the patients.

Methods: 103 leiomyoma patients under the age of 49 received different operation: myomectomy (Group I, n = 33), subtotal hysterectomy (Group II, n = 30), and hysterectomy (Group III, n = 40). The levels of serum estradiol (E(2)), progesterone (P), luteinizing hormone (LH), and follicle stimulating hormone (FSH) were detected before operations and 3 and 6 months after operations. Sixty patients underwent color Doppler ultrasonography before and after hysterectomy or subtotal hysterectomy to measure the blood flow of ovary artery. The maximal systolic flow velocity (Vmax), end-diastolic minimal flow velocity (Vmin), resistance index (RI), and pulsatility index (PI) were calculated.

Results: There were no significant differences in the levels of E(2), P, LH, and FSH before and after operation among the patients of Group I regardless of the age (all P > 0.05) The E(2) levels 6 months after operation of Group II and Group III were both significantly lower than those before operation (both P < 0.05), however, the P, LH, and FSH levels before and after operation were not significantly different in these 2 groups (all P > 0.05). The E(2) level 6 months after operation of the patients aged > or = 40 in group III decreased much more significantly to (362 +/- 252) pmol/L, with a greater statistical difference in comparison with that before operation, (567 +/- 417) pmol/L (P < 0.01). The values of Vmax and Vmin of the ovary artery 6 months after operation were: 0.24 +/- 0.04 m/s and 0.05 +/- 0.05 m/s respectively, both significantly lower than those before operation, (0.50 +/- 0.11 m/s and 0.17 +/- 0.24 m/s respectively, both P < 0.01). The values of RI and PI 6 months after operation were: 0.80 +/- 0.05 and 2.06 +/- 0.24 respectively, both significantly higher than those before operation (0.74 +/- 0.05 and 1.62 +/- 0.33 respectively, both P < 0.01).

Conclusion: Myomectomy doesn't influence the ovary function. Both subtotal hysterectomy and hysterectomy decrease the ovary blood flow and endocrine function 6 months after operations.