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CERRAHİ METODUN TÜRÜNE GÖRE HİSTEREKTOMİNİN AMELİYAT SONRASI ERKEN DÖNEMDE OVER REZERVİNE ETKİSİ

Yıl 2023, Cilt: 86 Sayı: 2, 123 - 129, 30.03.2023

Özden Öztürk Tayfur Çift Süleyman Serkan Karaşin

https://doi.org/10.26650/IUITFD.1210689

Öz

Amaç: Bu çalışmada yapılan histerektomi tipine göre over rezervinin ne kadar etkilendiğini tahmin etmeyi amaçladık. Gereç ve yöntem: Çalışmamız tek merkezli prospektif kesitsel bir çalışmadır. Temmuz 2021 ile Mart 2022 arasında benign histerektomi yapılan 82 hastayı dahil ettik. Abdominal histerektomi (n=54) ve laparoskopik (L/S) histerektomi (n=28) olmak üzere iki grup vardı. Histerektomi öncesi ve sonrası transvajinal ultrasonografi ve hormon durumu değerlendirildi. Ameliyat öncesi anti-Müllerian hormon (AMH) değeri 0,01 ng/dl’nin üzerinde ve folikül uyarıcı hormon (FSH) değeri 15 IU/L’nin altında olan hastalar çalışmaya alındı. Bulgular: Gruplar arasında yaş, parite, süre ve kanama açısından anlamlı fark vardı. Abdominal ve laparoskopik histerektomiler arasında AMH değerindeki azalma yüzdesi açısından anlamlı bir fark yoktu. Over hacmindeki azalma miktarı ve antral folikül sayısı (AFS) parametreleri açısından karşılaştırmada fark yoktu. Serum estradiol değerlerinin analizinde 33 hastada artış, 49 hastada düşüş gözlendi. Artanların %63,7’si, azalanların ise %67,3’ü abdominal histerektomi geçirenlerdi. Estradiol değerleri arasındaki fark istatistiksel olarak anlamlı değildi. FSH parametrelerindeki artış miktarı ve hızı açısından karşılaştırmalı analizde iki grup arasında fark vardı (p=0,03). Sonuç: Her iki grupta da ameliyat öncesi ve sonrası over rezervinde azalma gözlendi. Aralarında yapılan analizlerde anlamlı bir fark gözlenmedi. FSH düzeylerindeki artış L/S lehine daha anlamlıydı. Elektrotermal enerji kullanımına bağlı olarak over foliküllerinde inhibin-B düzeylerinin araştırılması da dahil olmak üzere, karın cerrahisine kıyasla L/S histerektominin yumurtalık rezervi üzerindeki etkisini araştırmak için prospektif büyük ölçekli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Histerektomi yumurtalık rezervi anti-mullerian hormon folikül uyarıcı hormon estradiol

Kaynakça

  • 1. Swaim LS. Abdominal Hysterectomy. In: Handa VL, Van Le L, editors. Te Linde’s Operative Gynecology, 12th Edition. Wolters Kluwer: Philadelphia (PA); 2020.p.365-87. google scholar
  • 2. Moawad G, Liu E, Song C, Fu AZ. Movement to outpatient hysterectomy for benign indications in the United States, 2008-2014. PLoS One 2017;12(11):e0188812. [CrossRef] google scholar
  • 3. Committee Opinion No 701: Choosing the Route of Hysterectomy for Benign Disease. Obstet Gynecol. 2017 Jun;129(6):e155-e159. [CrossRef] google scholar
  • 4. Aarts JW, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BW, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 2015;2015(8):CD003677. [CrossRef] google scholar
  • 5. Wang Y, Yuan Y, Meng D, Liu X, Gao Y, Wang F, et al. Effects of environmental, social and surgical factors on ovarian reserve: Implications for age-relative female fertility. Int J Gynaecol Obstet 2021;154(3):451-8. [CrossRef] google scholar
  • 6. Seyhan A, Ata B, Uncu G. The impact of endometriosis and its treatment on ovarian reserve. Semin Reprod Med. 2015 Nov;33(6):422-8. [CrossRef] google scholar
  • 7. Chun S, Ji YI. Effect of Hysterectomy on Ovarian Reserve in the Early Postoperative Period Based on the Type of Surgery. J Menopausal Med 2020;26(3):159-64. [CrossRef] google scholar
  • 8. Dayal M, Sagar S, Chaurasia A, Singh U. Anti-mullerian hormone: a new marker of ovarian function. J Obstet Gynaecol India 2014;64(2):130-3. [CrossRef] google scholar
  • 9. Cho H, Park ST, Kyung MS, Park S. Assessment of ovarian reserve after hysterectomy: Laparoscopic vs. non-laparoscopic surgery. Eur J Obstet Gynecol Reprod Biol X 2017;210:54-7. [CrossRef] google scholar
  • 10. Ata B, Turkgeldi E, Seyhan A, Urman B. Effect of hemostatic method on ovarian reserve following laparoscopic endometrioma excision; comparison of suture, hemostatic sealant, and bipolar dessication. A systematic review and meta-analysis. J Minim Invasive Gynecol 2015;22(3):363-72. [CrossRef] google scholar
  • 11. Ergun B, Ozsurmeli M, Dundar O, Comba C, Kuru O, Bodur S. Changes in markers of ovarian reserve after laparoscopic ovarian cystectomy. J Minim Invasive Gynecol 2015;22(6):997-1003. [CrossRef] google scholar
  • 12. Sezik M, Ozkaya O, Demir F, Sezik HT, Kaya H. Total salpingectomy during abdominal hysterectomy: effects on ovarian reserve and ovarian stromal blood flow. J Obstet Gynaecol Res 2007;33(6):863-9. [CrossRef] google scholar
  • 13. Findley AD, Siedhoff MT, Hobbs KA, Steege JF, Carey ET, McCall CA, et al. Short-term effects of salpingectomy during laparoscopic hysterectomy on ovarian reserve: a pilot randomized controlled trial. Fertil Steril 2013;100(6):1704-8. [CrossRef] google scholar
  • 14. Kaya F, Küçükkömürcü Ş, Gürün S, Öztaş A, Alarslan D, Develioğlu OH. Histolojik olarak tanımlanmış folikül havuzunu belirlemede over rezerv testlerinin değeri. J Clin Obstet Gynecol 2007;17(2):110-6. google scholar

THE EFFECT ON OVARIAN RESERVE IN THE EARLY POSTOPERATIVE PERIOD IN HYSTERECTOMY ACCORDING TO THE TYPE OF SURGERY

Yıl 2023, Cilt: 86 Sayı: 2, 123 - 129, 30.03.2023

Özden Öztürk Tayfur Çift Süleyman Serkan Karaşin

https://doi.org/10.26650/IUITFD.1210689

Öz

Objective: The aim of this study was to estimate the possible differential levels of influence of the applied hysterectomy type on ovarian reserve. Materials and Methods: Our study is a single-center prospective cross-sectional study. We included 82 patients who underwent benign hysterectomies between July 2021 and March 2022. There were two groups, abdominal hysterectomy (n=54) and laparoscopic (L/S) hysterectomy (n=28). Transvaginal ultrasonography and hormone status were evaluated before and after the hysterectomy. Patients with a preoperative anti-Mullerian hormone (AMH) value greater than 0.01 ng/dl and a follicle stimulating hormone (FSH) value less than 15 IU/L were included in the study. Results: There was a significant difference between the groups regarding age, parity, duration, and bleeding. There was no significant difference in the percent decrease in AMH value between abdominal and laparoscopic hysterectomies. There was no difference in the comparison regarding the amount of decrease in ovarian volume and antral follicle count (AFS) parameters. In the analysis of serum estradiol values, an increase in 33 patients and a decrease in 49 patients were observed. While serum estradiol values decreased in 33 of 54 patients who underwent abdominal hysterectomy, this rate was 67.3% among patients with decreased estradiol. The difference in estradiol values was not statistically significant. There was a difference between the two groups in the comparative analysis regarding the amount and rate of increase in FSH parameters (p=0.03). Conclusion: In both groups a decrease in ovarian reserve before and after surgery was observed. No significant difference was observed in the analyses performed between them. The increase in FSH levels was more significantly in favor of L/S. Prospective large-scale studies are needed to investigate the effect of L/S hysterectomy on ovarian reserve compared to abdominal surgery, including investigating inhibin-B levels in ovarian follicles due to electrothermal energy use.

Anahtar Kelimeler

Hysterectomy Ovarian Reserve Anti-Mullerian Hormone Follicle Stimulating Hormone Estradiol

Kaynakça

  • 1. Swaim LS. Abdominal Hysterectomy. In: Handa VL, Van Le L, editors. Te Linde’s Operative Gynecology, 12th Edition. Wolters Kluwer: Philadelphia (PA); 2020.p.365-87. google scholar
  • 2. Moawad G, Liu E, Song C, Fu AZ. Movement to outpatient hysterectomy for benign indications in the United States, 2008-2014. PLoS One 2017;12(11):e0188812. [CrossRef] google scholar
  • 3. Committee Opinion No 701: Choosing the Route of Hysterectomy for Benign Disease. Obstet Gynecol. 2017 Jun;129(6):e155-e159. [CrossRef] google scholar
  • 4. Aarts JW, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BW, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 2015;2015(8):CD003677. [CrossRef] google scholar
  • 5. Wang Y, Yuan Y, Meng D, Liu X, Gao Y, Wang F, et al. Effects of environmental, social and surgical factors on ovarian reserve: Implications for age-relative female fertility. Int J Gynaecol Obstet 2021;154(3):451-8. [CrossRef] google scholar
  • 6. Seyhan A, Ata B, Uncu G. The impact of endometriosis and its treatment on ovarian reserve. Semin Reprod Med. 2015 Nov;33(6):422-8. [CrossRef] google scholar
  • 7. Chun S, Ji YI. Effect of Hysterectomy on Ovarian Reserve in the Early Postoperative Period Based on the Type of Surgery. J Menopausal Med 2020;26(3):159-64. [CrossRef] google scholar
  • 8. Dayal M, Sagar S, Chaurasia A, Singh U. Anti-mullerian hormone: a new marker of ovarian function. J Obstet Gynaecol India 2014;64(2):130-3. [CrossRef] google scholar
  • 9. Cho H, Park ST, Kyung MS, Park S. Assessment of ovarian reserve after hysterectomy: Laparoscopic vs. non-laparoscopic surgery. Eur J Obstet Gynecol Reprod Biol X 2017;210:54-7. [CrossRef] google scholar
  • 10. Ata B, Turkgeldi E, Seyhan A, Urman B. Effect of hemostatic method on ovarian reserve following laparoscopic endometrioma excision; comparison of suture, hemostatic sealant, and bipolar dessication. A systematic review and meta-analysis. J Minim Invasive Gynecol 2015;22(3):363-72. [CrossRef] google scholar
  • 11. Ergun B, Ozsurmeli M, Dundar O, Comba C, Kuru O, Bodur S. Changes in markers of ovarian reserve after laparoscopic ovarian cystectomy. J Minim Invasive Gynecol 2015;22(6):997-1003. [CrossRef] google scholar
  • 12. Sezik M, Ozkaya O, Demir F, Sezik HT, Kaya H. Total salpingectomy during abdominal hysterectomy: effects on ovarian reserve and ovarian stromal blood flow. J Obstet Gynaecol Res 2007;33(6):863-9. [CrossRef] google scholar
  • 13. Findley AD, Siedhoff MT, Hobbs KA, Steege JF, Carey ET, McCall CA, et al. Short-term effects of salpingectomy during laparoscopic hysterectomy on ovarian reserve: a pilot randomized controlled trial. Fertil Steril 2013;100(6):1704-8. [CrossRef] google scholar
  • 14. Kaya F, Küçükkömürcü Ş, Gürün S, Öztaş A, Alarslan D, Develioğlu OH. Histolojik olarak tanımlanmış folikül havuzunu belirlemede over rezerv testlerinin değeri. J Clin Obstet Gynecol 2007;17(2):110-6. google scholar
Toplam 14 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm ARAŞTIRMA
Yazarlar

Özden Öztürk 0000-0002-5695-4407

Tayfur Çift 0000-0003-4025-9343

Süleyman Serkan Karaşin 0000-0002-4837-5114

Yayımlanma Tarihi 30 Mart 2023
Gönderilme Tarihi 27 Kasım 2022
Yayımlandığı Sayı Yıl 2023 Cilt: 86 Sayı: 2

Kaynak Göster

APA Öztürk, Ö., Çift, T., & Karaşin, S. S. (2023). THE EFFECT ON OVARIAN RESERVE IN THE EARLY POSTOPERATIVE PERIOD IN HYSTERECTOMY ACCORDING TO THE TYPE OF SURGERY. Journal of Istanbul Faculty of Medicine, 86(2), 123-129. https://doi.org/10.26650/IUITFD.1210689
AMA Öztürk Ö, Çift T, Karaşin SS. THE EFFECT ON OVARIAN RESERVE IN THE EARLY POSTOPERATIVE PERIOD IN HYSTERECTOMY ACCORDING TO THE TYPE OF SURGERY. İst Tıp Fak Derg. Mart 2023;86(2):123-129. doi:10.26650/IUITFD.1210689
Chicago Öztürk, Özden, Tayfur Çift, ve Süleyman Serkan Karaşin. “THE EFFECT ON OVARIAN RESERVE IN THE EARLY POSTOPERATIVE PERIOD IN HYSTERECTOMY ACCORDING TO THE TYPE OF SURGERY”. Journal of Istanbul Faculty of Medicine 86, sy. 2 (Mart 2023): 123-29. https://doi.org/10.26650/IUITFD.1210689.
EndNote Öztürk Ö, Çift T, Karaşin SS (01 Mart 2023) THE EFFECT ON OVARIAN RESERVE IN THE EARLY POSTOPERATIVE PERIOD IN HYSTERECTOMY ACCORDING TO THE TYPE OF SURGERY. Journal of Istanbul Faculty of Medicine 86 2 123–129.
IEEE Ö. Öztürk, T. Çift, ve S. S. Karaşin, “THE EFFECT ON OVARIAN RESERVE IN THE EARLY POSTOPERATIVE PERIOD IN HYSTERECTOMY ACCORDING TO THE TYPE OF SURGERY”, İst Tıp Fak Derg, c. 86, sy. 2, ss. 123–129, 2023, doi: 10.26650/IUITFD.1210689.
ISNAD Öztürk, Özden vd. “THE EFFECT ON OVARIAN RESERVE IN THE EARLY POSTOPERATIVE PERIOD IN HYSTERECTOMY ACCORDING TO THE TYPE OF SURGERY”. Journal of Istanbul Faculty of Medicine 86/2 (Mart 2023), 123-129. https://doi.org/10.26650/IUITFD.1210689.
JAMA Öztürk Ö, Çift T, Karaşin SS. THE EFFECT ON OVARIAN RESERVE IN THE EARLY POSTOPERATIVE PERIOD IN HYSTERECTOMY ACCORDING TO THE TYPE OF SURGERY. İst Tıp Fak Derg. 2023;86:123–129.
MLA Öztürk, Özden vd. “THE EFFECT ON OVARIAN RESERVE IN THE EARLY POSTOPERATIVE PERIOD IN HYSTERECTOMY ACCORDING TO THE TYPE OF SURGERY”. Journal of Istanbul Faculty of Medicine, c. 86, sy. 2, 2023, ss. 123-9, doi:10.26650/IUITFD.1210689.
Vancouver Öztürk Ö, Çift T, Karaşin SS. THE EFFECT ON OVARIAN RESERVE IN THE EARLY POSTOPERATIVE PERIOD IN HYSTERECTOMY ACCORDING TO THE TYPE OF SURGERY. İst Tıp Fak Derg. 2023;86(2):123-9.
 Kapak Resmi İndir

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