Assessment of quality of life after hysterectomy with opportunistіс salpingeсtomy with uterine myoma by vaginal and abdominal access

Authors

DOI:

https://doi.org/10.15587/2519-4798.2022.252941

Keywords:

uterine fibroids, hysterectomy, quality of life parameters, opportunistic salpingectomy

Abstract

The aim of the research – to identify violations of quality of life after hysterectomy with opportunistic salpingectomy, considering different approaches to surgery.

Materials and methods. Quality of life assessments of hysterectomy with opportunistic salpingectomy for uterine fibroids were performed in 160 women of reproductive age, who were divided into two groups: I – 90 patients with vaginal access, and II – 70 patients with abdominal access. The control group included 50 women with asymptomatic fibroids of reproductive age. The diagnostic algorithm included a physical examination, ultrasound examination of the pelvic organs, assessment of urogenital dysfunction questionnaire using the MOS SF-36 questionnaire; to identify signs of vegetative changes in Wayne, to assess general fatigue, physical and mental fatigue MFI-20 was performed using a standardized POP-Q system.

Results. The leading violations of quality-of-life parameters are general somatic symptoms 107 (66.9±6.0 %), psycho-emotional disorders 89 (55.6±6.7 %), genitourinary and sexual disorders 39 (24.4±3.0 %). Among the most common somatic ones – complaints of headaches, edema and fluctuations in blood pressure. The dominance of asthenic, anxiety and depressive disorders among psycho-emotional disorders has been established. The diagnosis of “organic asthenic disorder” was established in 47 (52.2±9.7 %) and 39 (55.7±7.3 %), respectively, in the groups of examined patients. Vaginal hysterectomy causes more increase in the proportion of urogenital disorders 25 27.7±8.3 %) compared to control – 7 (14.0±4.8 %) (p<0.05). An ultrasound examination showed a 2.25-fold increase in ovarian volume one month after the hysterectomy, and a reduction in ovarian tissue volume in both study groups 2 years after surgery.

Conclusions. Hysterectomy with opportunistic salpingectomy affects the parameters of quality of life. The leading violations of quality-of-life parameters are general somatic symptoms, psycho-emotional disorders without statistically significant difference in groups, but the indicators are better in group I. The minimal effect on ovarian function and size was determined – 2 years after surgery, there was a decrease in ovarian tissue volume in both study groups, but statistically significant – in the second group (3.12±0.7 cm3, p<0.05) against the data control (5.82±1.7 cm3). Although the results showed a more frequent manifestation of pelvic floor descent in vaginal access, quality of life parameters were higher in these patients. Given its safety, efficiency and cost-effectiveness, it is advisable to choose it as a method of choice

Author Biographies

Olha Proshchenko, Bogomolets National Medical University

PhD, Assistant

Department of Obstetrics and Gynecology No. 1

Iryna Ventskivska, Bogomolets National Medical University

Doctor of Medical Sciences, Head of Department

Department of Obstetrics and Gynecology No. 1

Yaroslav Vitovsky, Bogomolets National Medical University

PhD, Associate Professor

Department of Obstetrics and Gynecology No. 1

Svitlana Markitanyuk, Kyiv Perinatal Center

PhD, Obstetrician-Gynecologist

References

  1. Fernandez, H., Farrugia, M., Jones, S. E., Mauskopf, J. A., Oppelt, P., Subramanian, D. (2009). Rate, Type, and Cost of Invasive Interventions for Uterine Myomas in Germany, France, and England. Journal of Minimally Invasive Gynecology, 16 (1), 40–46. doi: http://doi.org/10.1016/j.jmig.2008.09.581
  2. Zabolotnov, V. A., Karapetian, O. V., Pamfamirov, Iu. K., Pamfamirova, G. L., Kucherenko, Iu. A., Tatevosian, A. G. (2011). Sovremennye vzgliady na etiologiiu, patogenez i lechenie miomy matki. Zdorove zhenschiny, 5 (61), 15–20.
  3. Stewart, E. A., Shuster, L. T., Rocca, W. A. (2012). Reassessing Hysterectomy. Minnesota Medicine, 95 (3), 36–39.
  4. Lashkul, О. S. (2018). Quality of life and sexual function of women operated on reproductive system organs. Zaporozhye Medical Journal, 20 (1 (106)), 7681. doi: http://doi.org/10.14739/2310-1210.2018.1.121999
  5. Vomvolaki, E., Kalmantis, K., Kioses, E., Antsaklis, A. (2006). The effect of hysterectomy on sexuality and psychological changes. The European Journal of Contraception & Reproductive Health Care, 11 (1), 23–27. doi: http://doi.org/10.1080/13625180500430200
  6. Roseske, N. C. (2007). Hysterectomy and other gynecological surgeries: a psychological view. Women’s place in medical and psychological interfaces, 1, 172–180.
  7. Van Lieshout, L. A. M., Steenbeek, M. P., De Hullu, J. A., Vos, M. C., Houterman, S., Wilkinson, J., Piek, J. M. (2019). Hysterectomy with opportunistic salpingectomy versus hysterectomy alone. Cochrane Database of Systematic Reviews, 8. doi: http://doi.org/10.1002/14651858.cd012858.pub2
  8. Evstifeeva, E. A., Filippchenkova, S. I., Kalantarov, T. K., Kholodin, S. P. (2016). Psikhosomaticheskaia sostavliaiuschaia i kachestvo zhizni bolnykh khirurgicheskogo profilia. Arkhiv vnutrennei meditsiny. Spetsialnyi vypusk, 61.
  9. Zagorodniaia, E. D., Barkan, T. M., Kolecnikov, A. D., Barkan, V. C., Rezanovich, V. C., Butunov, A. A., Tseliuba, E. A. (2013). Vliianie gicterektomii na funktsiiu iaichnikov i kachectvo zhizni bolnykh miomoi matki. Akusherctvo i ginekologiia, 2, 48–81.
  10. Savvina, N. V., Savvina, A. D. et. al. (2013). Kachestvo zhizni kak pokazatel effektivnosti reabilitatsionnykh meropriiatii. Vestnik natsionalnogo mediko-khirurgicheskogo tsentra im. N. I. Pirogova, 3 (8), 41–43.

Downloads

Published

2022-01-30

How to Cite

Proshchenko, O., Ventskivska, I., Vitovsky, Y. ., & Markitanyuk, S. (2022). Assessment of quality of life after hysterectomy with opportunistіс salpingeсtomy with uterine myoma by vaginal and abdominal access . ScienceRise: Medical Science, (1 (46), 25–30. https://doi.org/10.15587/2519-4798.2022.252941

Issue

Section

Medical Science