The effects of surgical treatments of dysfunctional uterine bleeding on ovarian function
LI Feiyan;Yang Li;REN Chenchen;BAI Yang;REN Ruifang;ZHAO Na;XUE Jingge;LI Majun;Department of Obstetrics and Gynecology, Third Affiliated Hospital of Zhengzhou University;
Objectives: To investigate the effects of different surgical interventions in the treatment of dysfunctional uterine bleeding on women's ovarian function. Methods: We selected dysfunctional uterine bleeding patients whom underwent the surgical treatments in the Third Affiliated Hospital of Zhengzhou University from January 2013 to January 2014. All the patients completed the follow-up were divided into three groups according to the ways of surgery, i.e. transcervical resection of endometrium(TCRE group), the simple laparoscopic hysterectomy group and the laparoscopic hysterectomy + bilateral tubal resection group. The changes of preoperative and postoperative hormone levels at 1, 3, 6 months were all observed in order to learn about the influences on ovarian function. Results: The P value of five hormone levels in three intervention groups before the surgery was more than 0.05, the difference has no statistical significance. The five hormone levels of the TCRE group were no changed and when compared with the preoperative, there still has no significant difference. After hysterectomy(including retain oviduct and resection of oviduct), the FSH and LH levels were all increased, while the E2 and P levels were decreased, T levels had no obvious changes, there was no significant difference between the preoperative and postoperative 1 months. But at 3 and 6 months, there was a significant difference compared with the preoperative P0.05. Comparison of 5 hormone levels in the Hysterectomy(including retain oviduct and resection of oviduct) group at 1, 3, 6 months in between groups, there were all no significant difference. Compared with the TCRE group, the difference has no statistical significance after surgery 1 month, while the P values of FSH, LH, E2 at 3, 6 months after surgery were all more than 0.05. However, the P value of T levels was more than 0.05 and means there was no significant difference. Conclusion: Different surgical interventions in the treatment of dysfunctional uterine bleeding may have different effects on ovarian function. The hysterectomy may cause ovarian function decline in premenopausal women and simultaneous resection of oviduct does not increase the influence of ovarian function in premenopausal women, the same effects can also be seen in the transcervical resection of endometrium group.