[Evaluation of the clinical value of simultaneous hysterectomy and bilateral salpingectomy in perimenopausal women].

OBJECTIVE: To investigate the effects on pelvic pseudocyst, ovarian function and symptoms of peri-menopausal period in patients with benign uterine disease undergoing simultaneous hysterectomy and bilateral salpingectomy. METHODS: From Jan. 2000 to Dec. 2006, 1193 patients with benign uterine disease underwent total or subtotal hysterectomy, they were followed up for 48 months, 334 patients lost follow-up, the other 859 patients were divided into 2 groups, including 348 patients undergoing simultaneous hysterectomy and bilateral salpingectomy in study group and 511 patients undergoing only hysterectomy in control group. The occurrence of pelvic pseudocyst and symptoms of peri-menopausal period and the changes of serum sexual hormone were observed. RESULTS: (1) The rate of pelvic pseudocyst was 1.7% (6/348) in study group, which was significantly lower than 4.3% (22/511) in control group (P = 0.036). (2) There was an increasing trend of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and a decreasing trend of estradiol (E(2)) at range of 6 - 48 months after surgery. At 3 months after surgery, LH in study group was significantly higher than that in control group [(13.9 ± 2.2) U/L vs. (12.6 ± 2.5) U/L, P = 0.032]; FSH in study group at 6 months and 12 months after surgery were (17.6 ± 2.2) U/L and (26.7 ± 5.0) U/L, which were significantly higher than (16.2 ± 2.8) U/L and (24.3 ± 3.1) U/L in control group (P = 0.035 and P = 0.031). At 12 months after surgery, LH in study group of (24.1 ± 3.0) U/L was significantly higher than (22.5 ± 1.8) U/L in control group (P = 0.017). E(2) in control group of (97 ± 22) pmol/L was significantly lower than (109 ± 17) pmol/L in control group at 24 months after surgery (P = 0.028); FSH in study group was lower than that in control group at 48 months after surgery [(34.9 ± 6.7) U/L vs. (38.0 ± 4.8) U/L, P = 0.043]. There were no significant differences of FSH, LH, and E(2) between two groups at the other time points (P > 0.05). (3) At 6 months after surgery, the rate of perimenopausl systems of 21.8% (76/348) in study group was significantly higher than 15.9% (81/511) in control group (P = 0.026). However, at 24 months after surgery, the rate of perimenopausal symptoms of 54.4% (278/511) in control group was significantly higher than 47.1% (164/348) in study group (P = 0.036). CONCLUSION: Simultaneous hysterectomy and bilateral salpingectomy could decrease the occurrence of pelvic pseudocyst, and had similar effects on ovarian function and peri-menopausal symptoms compared with only hysterectomy in patients with benign uterine diseases.