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| Effects of surgical decision-making based on the situation of uterine preservation during hysterectomy of patients with uterine fibroids on their postoperative physical and psychological health |
| The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, 050000 |
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Abstract To compare the effects of the total hysterectomy and the subtotal hysterectomy of patients with uterine fibroids on their postoperative physical and psychological health. Methods: 86 patients with uterine fibroids admitted to hospital were selected and were divided into two groups (43 cases in each group) based on different hysterectomy method from March 2019 to May 2024. The patients in group A were given total hysterectomy and the patients in group B were given subtotal hysterectomy. The ovarian function, such as the antral follicle count and the levels of serum estradiol (E2), luteinizing hormone (LH) and folliclestimulating hormone (FSH) before surgery and in 3 and 6 months after surgery, the negative psychology evaluated by self-rating anxiety scale (SAS), selfrating depression scale (SDS), Pittsburgh sleep quality index (PSQI) and female sexual function index (FSFI), the persisted symptoms situation before surgery and the complications rate of the patients in the two groups were recorded. Results: The sinus follicle number of the patients in group B in 3 postoperative months had no significant change (P>0.05). The serum E2 level, the scores of SAS, SDS and PSQI, the sexual desire, the situations of the vaginal lubrication and pain, the sexual arousal, the orgasm and the sexual satisfaction during sex, and the FSFI total score of the patients in two groups had decreased significantly, however, the levels of LH and FSH, and the scores of SAS, SDS and PSQI of the patients in two groups had increased significantly. The sinus follicle number, the serum E2 level, the sexual desire, the situations of the vaginal lubrication, dyspareunia, sexual arousal, orgasm and satisfaction, and the FSFI total score of the patients in the in group A were significantly lower than those of the patients in group B, and the LH and FSH levels of the patients in group A were significantly higher than those of the patients in group B (P<0.05). The scores of SAS (56.24±2.19 points), SDS (60.34±2.58 points), PSQI (11.95±2.71 points) of the patients in group A in 6 months after surgery were significantly lower than those (62.05±2.34 points, 66.18±3.19 points and 14.09±2.48 points) of the patients in group B (P<0.05). There was no significant difference in the postoperative complications rate (11.6% vs. 20.9%) of the patients between the two groups (P>0.05). Conclusion: For the patients with uterine fibroids who have indications for the hysterectomy, the total hysterectomy of the patients has more impact on the postoperative ovarian function and the sexual quality of life comparing those of the subtotal hysterectomy. However, the hidden dangers of the subtotal hysterectomy maybe lead to the negative emotions of the patients. It is recommended that the discuss with the patients before surgery to help them make a more rational decision in clinic.
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