Objective To evaluate the short-term and long-term effects of different surgical methods for uterine myoma on ovarian function by detecting the serum levels of AMH and postoperative modified Kupperman score.Methods From January 2014 to July 2015, 120 uterine fibroids patients underwent surgery, including uterine myomectomy group (group A, n=40), hysterectomy group (group B, n=40), and hysterectomy plus bilateral tubal resection group (group C, n=40). Serum AMH levels were detected and compared among the three groups before 2 days of surgery and after 1, 6, and 12 months of surgery, and modified Kupperman scores at corresponding time points were also detected to assess the severity of perimenopausal symptoms.Results For group B and group C, AMH levels were significantly lower at postoperative 6 and 12 months than preoperative 2 days (P<0.05). Compared with group A, group B and group C showed significantly lower levels of AMH at postoperative 6 and 12 months (P<0.05). For group B and group C, modified Kupperman score did not change at postoperative 1 month (P>0.05), but increased significantly at postoperative 6 and 12 months (P<0.05) compared with preoperative 2 days. Compared with group A, group B and group C showed higher modified Kupperman scores at postoperative 6 and 12 months (P<0.01).Conclusion Myomectomy (control group) has little effects on ovarian function, but its clinical effect is comparable to subtotal hysterectomy. The patients receiving hysterectomy or hysterectomy with bilateral tubal resection result in decreased ovarian function at postoperative 6 and 12 months. Therefore, myomectomy is a preferred treatment for uterine myoma without affecting ovarian function.
FENG Jun
,
HOU Fang
,
PENG Jie
. Effects of different surgical treatments for uterine myoma on ovarian function[J]. Surgical Research and New Technique, 2018
, 7(1)
: 41
-44
.
DOI: 10.3969/j.issn.2095-378X.2018.01.012
[1] 金影,靳家玉.残留卵巢综合征20例诊治分析[J].中国误诊学杂志,2009,9(9):2214-2215.
[2] 曹斌融,罗成燕.残留卵巢综合征与卵巢残余物综合征[J].中国实用妇科与产科杂志,2006,22(5):330-332.
[3] 曹泽毅.中华妇产科学(下册)[M].2版.北京:人民卫生出版社,2004:2537.
[4] 陶素萍,杨晓敏,叶小燕,等.合并输卵管切除术的子宫全切术对卵巢功能影响的研究[J].浙江创伤外科,2014,18(3):382-383.
[5] Freeman EW, Sammel MD, Hui Lin, et al.Anti-Miillerian hormone as a predictor of time to menopause in late reproductive age women[J].J Clin Endocrinol Metab,2012,97(5):1673-1680.
[6] Naasan MN, Harrity C, Pentony L, et al.Anti-mullerian hormone normogram in an Irish subfertile population[J].Irish Jf Med Sci,2015,184(1):213-218.
[7] Kim JY, Jee BC, Suh CS, et al.Preoperative serum anti-Miillerian hormone level in women with ovarian endometrioma and mature cystic teratoma[J].Yonsei Med J,2013,54(4):921-926.
[8] 陈翠莹,游可理.全子宫及双侧输卵管切除对术后卵巢功能的近期影响[J].医学研究生学报,2017,30(1):83-84.