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绝经过渡期或绝经后妇女预防性卵巢切除术对情绪和性功能的影响。

Influence of prophylactic oophorectomy on mood and sexual function in women of menopausal transition or postmenopausal period.

机构信息

Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, 419 Fangxie Rd, Shanghai, 200000, People's Republic of China.

出版信息

Arch Gynecol Obstet. 2013 Nov;288(5):1101-6. doi: 10.1007/s00404-013-2865-1. Epub 2013 Apr 27.

DOI:10.1007/s00404-013-2865-1
PMID:23625334
Abstract

AIM

To evaluate the impact of prophylactic oophorectomy on mood and sexual function in women at menopausal transition or postmenopausal period.

METHODS

Patients who underwent operations due to benign diseases of uterus and ovaries were included and were stratified into two groups, namely Group A with 256 patients undergoing hysterectomy and prophylactic oophorectomy and Group B with 337 patients undergoing simple hysterectomy. Follow-ups included demographic data, Self-Rating Zung Depression Scale (ZDS), Self-Rating Zung Anxiety Scale (ZAS), and Female Sexual Function of Index (FSFI).

RESULTS

Five hundred and ninety-three patients were successfully followed. 69.27 % of patients at menopausal transition period chose ovary conservation whilst 79.22 % of postmenopausal women chose oophorectomy due to fear of potential cancer and economy issue. Ovarian cancer was not found in this cohort. Incidence of distress was higher in Group A (P = 0.001). No difference was obtained in ZAS scores between the two groups (P = 0.110). Incidence of anxiety was higher in Group A (P = 0.010). Percentage of patients scoring above 20 in FSFI was significantly higher in Group B (P = 0.003). Oophorectomy and marital status were independent factors for depression (P = 0.009 and <0.001, respectively).

CONCLUSION

Adverse influence on mental and sexual status was severer in women undergoing prophylactic oophorectomy at menopausal transition or postmenopausal period. Comprehensive evaluation may contribute to better ovary conservation strategy for women with benign morbidities.

摘要

目的

评估绝经过渡期或绝经后女性预防性卵巢切除术对情绪和性功能的影响。

方法

纳入因子宫和卵巢良性疾病接受手术的患者,并分为两组,A 组 256 例行子宫切除术和预防性卵巢切除术,B 组 337 例行单纯子宫切除术。随访包括人口统计学数据、自评抑郁量表(ZDS)、自评焦虑量表(ZAS)和女性性功能指数(FSFI)。

结果

593 例患者成功随访。69.27%的绝经过渡期患者选择保留卵巢,而 79.22%的绝经后女性因担心潜在癌症和经济问题而选择卵巢切除术。本队列中未发现卵巢癌。A 组(P=0.001) distress 发生率较高。两组 ZAS 评分无差异(P=0.110)。A 组焦虑发生率较高(P=0.010)。B 组 FSFI 评分>20 的患者比例明显较高(P=0.003)。卵巢切除术和婚姻状况是抑郁的独立因素(P=0.009 和<0.001)。

结论

绝经过渡期或绝经后女性行预防性卵巢切除术对精神和性功能的不良影响更严重。对有良性疾病的女性进行全面评估有助于更好地保留卵巢。

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