Aziz Adel, Bergquist Christer, Brännström Mats, Nordholm Lena, Silfverstolpe Gunnar
Department of Obstetrics and Gynecology, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
Acta Obstet Gynecol Scand. 2005 Sep;84(9):854-9. doi: 10.1111/j.0001-6349.2005.00658.x.
Retrospective studies have indicated differences in sexuality and general psychological well-being between women who have undergone hysterectomy only and those undergoing hysterectomy and oophorectomy. These differences may be the result of dissimilarities in the groups of women who choose the respective operation.
To compare the preoperative characteristics of women who choose to undergo prophylactic oophorectomy with the corresponding characteristics of those who choose to retain their ovaries when undergoing hysterectomy on benign indication.
Perimenopausal women (aged 45-55), scheduled for hysterectomy on benign indication, were evaluated within 2 months before surgery. A total of 217 women chose hysterectomy only and 106 women chose hysterectomy with concomitant prophylactic oophorectomy.
Socioeconomic and health data, personality (Karolinska Scale of Personality), sexuality (McCoy's Female Sexuality Questionnaire), well-being (Psychological General Well-Being index), the prevalence of climacteric symptoms (modified Kupperman's index) and the women's attitude to hormone replacement therapy were investigated.
Women who later underwent prophylactic oophorectomy in addition to hysterectomy had higher anxiety-related scores, lower sexual variable scores and poorer emotional partner relationships. This group was also characterized by more episodes of irregular bleeding, a greater prevalence of climacteric symptoms and a more extensive use of hormonal replacement therapy, in comparison with women who later underwent hysterectomy only.
Personality, sexuality and the nature and severity of preoperative symptoms in women who chose prophylactic oophorectomy differ markedly from the same variables in those who chose to keep their ovaries at elective hysterectomy. These differences must be taken into consideration when evaluating studies comparing these aspects of quality of life after hysterectomy or hysterectomy with concomitant oophorectomy. Furthermore, psychosexual aspects such as sexuality and well-being can not be reliably studied with a retrospective design in these patient groups.
回顾性研究表明，仅接受子宫切除术的女性与接受子宫切除术和卵巢切除术的女性在性方面和总体心理健康状况存在差异。这些差异可能是由于选择相应手术的女性群体不同所致。
比较因良性指征接受子宫切除术时选择预防性卵巢切除术的女性与选择保留卵巢的女性的术前特征。
计划因良性指征接受子宫切除术的围绝经期女性（45 - 55岁）在手术前2个月内接受评估。共有217名女性选择仅行子宫切除术，106名女性选择子宫切除术并同时进行预防性卵巢切除术。
调查社会经济和健康数据、人格（卡罗林斯卡人格量表）、性（麦科伊女性性问卷）、幸福感（心理总体幸福感指数）、更年期症状患病率（改良库珀曼指数）以及女性对激素替代疗法的态度。
除子宫切除术外还接受预防性卵巢切除术的女性焦虑相关得分较高，性变量得分较低，情感伴侣关系较差。与仅接受子宫切除术的女性相比，该组还表现为不规则出血发作次数更多、更年期症状患病率更高以及激素替代疗法使用更广泛。
选择预防性卵巢切除术的女性在人格、性方面以及术前症状的性质和严重程度与选择在选择性子宫切除术中保留卵巢的女性在相同变量上存在显著差异。在评估比较子宫切除术或子宫切除术加卵巢切除术后生活质量这些方面的研究时，必须考虑这些差异。此外，在这些患者群体中，采用回顾性设计无法可靠地研究性和幸福感等心理性方面的问题。
