[Symptoms of ovarian failure after hysterectomy in premenopausal women. A retrospective study based on postoperative perception of 245 women].

A total of 437 patients who had undergone hysterectomy in the department of Obstetrics and Gynaecology, Heinrich Braun Clinic, Zwickau, between 1982 and 1992 were asked about vegetative and psychological problems after the operation. All were under 42 years old and had at least one ovary left intact. In all, 245 women returned the questionnaires. After hysterectomy 26.1% reported ovarian failure and 36.7% did not observe typical menopausal symptoms. Symptoms were significantly more frequent in patients where ovary had been removed. It made no difference whether a vaginal or an abdominal incision had been made. Psychic problems were reported by 17.6% of the patients. Patients with ovarian failure had more negative symptoms. Postoperatively, 34 women received hormonal therapy, and 10 of them finished the therapy successfully. The rate of ovarian failure and psychic symptoms can be reduced by adequate information before and after hysterectomy. A decision to perform a hysterectomy should be made only if the operations is strictly indicated. Prophylactic oophorectomy should not be performed in patients under 50 years. Effective hormonal substitution is recommended for patients with menopausal symptoms.