Long-term effects of hysterectomy due to uterine fibroids in women of reproductive age
The article presents an analytical assessment of long-term postoperative consequences in women of reproductive age after hysterectomy for uterine fibroids.
The aim of the study to determine the structure of long-term results of hysterectomy for uterine fibroids in women of reproductive age using different approaches to the possibility of optimizing the diagnostic algorithm in the preoperative period in the future.
Materials and methods – 160 women aged 40 to 50 years with symptomatic uterine fibroids, who underwent hysterectomy performed by vaginal, laparoscopically assisted vaginal, abdominal, were examined. Research methods are the following: physical examination of patients, assessment of pelvic floor (cough test, Valsalva maneuver, “Stop Test” with Kegel cones), diagnosis of urogenital dysfunction using a standardized POP-Q system; instrumental examination:, complete urodynamic testing, cystometry, (for assessment of the severity of urinary incontinence the classification of the International Continence Society (ICS) was used); assessment of the patient’s quality of life on the 10th day after surgery, 3, 6, 12 months and three years after surgery using the international standard questionnaire MOS SF-36; study of the local infectious status of the female body (bacteriological and bacterioscopic examination of discharge from vagina and urethra, determination of vaginal pH
Results and their discussion. The structure of distant postoperative manifestations was determined (after 36 months of postoperative monitoring): clinical manifestations of intestinal function discomfort in the same degree in patients of three subgroups, 2.4 and 2.9 times less often in group I patients indicated chronic pelvic pain, in 1.7 times less often - for genitourinary disorders, vaginal prolapse in a third of cases, especially in women with abdominal HE and classic vaginal HE (30.0±5.0 % and 37.8±5.0 %, respectively, against 17.8±4.0 % – in the group with laparotomically assisted HE).
Conclusions. Given the data on genitourinary disorders and vaginal prolapse in almost a third of observations after hysterectomy for uterine fibroids, it is advisable to consider additional examination of latent signs of genitourinary syndrome at the preoperative stage to optimize the choice of access, the volume of surgical treatment.
Lue, T. F., Basson, R., Rosen, R., Giuliano, F., Khoury, S., Montossi, F. (Eds.) (2004). Sexual Medicine. Sexual Dysfunction in Men and Women. 2nd International Consultation on Sexual Dysfunction. Paris, 991.
Lalaian, R. S., Petrov, Iu. A. (2017). Genitourinarnii sindrom i ego medikamentoznaia korrektsiia. Sovremennye problemy nauki i obrazovaniia, 2, 21–35.
Postman, D. J., Gass, M. L. (2014). Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and the North American Menopause Society. Menopause, 21 (10), 1063–1068. doi: http://doi.org/10.1016/j.maturitas.2014.07.013
Kuo, Y.-C., Kuo, H.-C. (2011). Potential factors that can be used to differentiate between interstitial cystitis/painful bladder syndrome and bladder oversensitivity in women. International Journal of Clinical Practice, 66 (2), 146–151. doi: http://doi.org/10.1111/j.1742-1241.2011.02767.x
The 2017 hormone therapy position statement of The North American Menopause Society (2017). Menopause, 24 (7), 728–753. doi: http://doi.org/10.1097/gme.0000000000000921
Vaughan, C. P., Markland, A. D. (2020). Urinary Incontinence in Women. Annals of Internal Medicine, 172 (3), ITC17. doi: http://doi.org/10.7326/aitc202002040
Brubaker, L., Richter, H. E., Norton, P. A., Albo, M., Zyczynski, H. M. et. al. (2012). 5-Year Continence Rates, Satisfaction and Adverse Events of Burch Urethropexy and Fascial Sling Surgery for Urinary Incontinence. Journal of Urology, 187 (4), 1324–1330. doi: http://doi.org/10.1016/j.juro.2011.11.087
Nappi, R. E., Palacios, S., Panay, N., Particco, M., Krychman, M. L. (2015). Vulvar and vaginal atrophy in four European countries: evidence from the European REVIVE Survey. Climacteric, 19 (2), 188–197. doi: http://doi.org/10.3109/13697137.2015.1107039
Robinson, D., Toozs-Hobson, P., Cardozo, L. (2013). The effect of hormones on the lower urinary tract. Menopause International, 19 (4), 155–162. doi: http://doi.org/10.1177/1754045313511398
Copyright (c) 2021 Olha Proshchenko, Iryna Ventskivska, Natalia Kamuz
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.