Khadilkar Suvarna
Mumbai, India.
J Obstet Gynaecol India. 2020 Apr;70(2):99-102. doi: 10.1007/s13224-020-01308-6. Epub 2020 Mar 18.
Ovarian function after hysterectomy is a subject of much controversy since many years. There is increasing awareness among gynecologists that the ovaries need to be spared at hysterectomy for benign conditions. However the awareness is limited, and many practitioners believe in removal of ovaries at hysterectomy. Removal of ovaries will save lives of patients at risk of developing ovarian cancer. But it will be unnecessary for low-risk women and will in fact endanger their lives by increasing cardiac risks. Recent data suggest that ovarian epithelial cancer arises from tubal epithelium, which adds new option of performing only salpingectomy and sparing ovaries, which will serve dual purpose of preventing ovarian cancer and continuing productive function of ovaries. Reproductive function is lost with hysterectomy. But it may be worth looking at impact of hysterectomy on productive function of ovaries. This editorial will focus on this issue and look at evidence on effects of other gynecological procedures on ovarian function.
多年来，子宫切除术后的卵巢功能一直是一个备受争议的话题。妇科医生越来越意识到，对于良性疾病，子宫切除时应保留卵巢。然而，这种意识有限，许多从业者认为子宫切除时应切除卵巢。切除卵巢将挽救有患卵巢癌风险的患者的生命。但对于低风险女性来说，这是不必要的，实际上还会因增加心脏风险而危及她们的生命。最近的数据表明，卵巢上皮癌起源于输卵管上皮，这增加了仅进行输卵管切除术并保留卵巢的新选择，这将起到预防卵巢癌和维持卵巢生殖功能的双重作用。子宫切除会导致生殖功能丧失。但或许值得研究子宫切除对卵巢生殖功能的影响。本社论将聚焦于此问题，并审视其他妇科手术对卵巢功能影响的证据。
