Study of Influence on Ovarian Function by HIFU and Surgical Treatment for Uterine Fibroids

doi:10.3877/cma.j.issn.1673-5250.2012.04.019

Objective

To explore the influence on ovarian function by HIFU, myomectomy, and hysterectomy for uterine fibroids.

Methods

From January 2008 to December 2010, 90 women with uterine fibroids were included in the study, and divided into high intensity focused ultrasound (HIFU)group(n=30), myomectomy group(n=30) and hysterectomy group(n=30) according to treatment method. Measure and compare the serum follicle-stimulating hormone (FSH), luteinizing hormone(LH)and estradiol hormone(E₂) level changes at 6 months before and after treatment.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Futian People's Hospital of Shenzhen. Informed consent was obtained from each patient. There has no significant differences between ages, clinical symptom and clinical classification among three groups(P>0.05).

Results

No significant difference was found in hormone levels between preoperative and 6 months after treatment in HIFU group and myomectomy group. 6 months after hysterectomy, FSH, LH increased and E₂ decreased which were significant differences compared to preoperative(P<0.05). There had significant differences of hormone level change between HIFU group and hysterectomy group in 6 months after treatment.

Conclusions

HIFU treatment for childbearing age women with uterine fibroids does not influence the ovarian function.

Key words: high intensity focused ultrasound, uterine fibroids, surgery, ovarian function

表1 3组患者一般情况比较[n(%)]

Table 1 Comparison of general condition among three groups[n(%)]

组别	n	平均年龄(岁)	临床症状		肌瘤类别
组别	n	平均年龄(岁)	子宫出血	下腹胀痛	肌壁间肌瘤	浆膜下肌瘤	黏膜下肌瘤
HIFU组	30	38.8	21(70.0)	20(66.7)	25(83.3)	3(10.0)	2(6.7)
肌瘤剔除组	30	38.4	20(66.7)	20(66.7)	24(80.0)	5(16.7)	1(3.3)
全子宫切除组	30	39.1	22(73.3)	19(63.3)	23(76.7)	5(16.7)	2(6.7)
P	?	?	>0.05		>0.05

表1 3组患者一般情况比较[n(%)]

Table 1 Comparison of general condition among three groups[n(%)]

组别	n	平均年龄(岁)	临床症状		肌瘤类别
组别	n	平均年龄(岁)	子宫出血	下腹胀痛	肌壁间肌瘤	浆膜下肌瘤	黏膜下肌瘤
HIFU组	30	38.8	21(70.0)	20(66.7)	25(83.3)	3(10.0)	2(6.7)
肌瘤剔除组	30	38.4	20(66.7)	20(66.7)	24(80.0)	5(16.7)	1(3.3)
全子宫切除组	30	39.1	22(73.3)	19(63.3)	23(76.7)	5(16.7)	2(6.7)
P	?	?	>0.05		>0.05

表2 3组患者术前及术后6个月激素水平变化比较(±s)

Table 2 Comparison of serum hormone levels among three groups 6 months after treatment(±s)

组别	n	FSH (mIU/mL)			LH(mIU/mL)			E₂(pg/mL)
组别	n	术前	术后6个月	P	术前	术后6个月	P	术前	术后6个月	P
HIFU组	30	7.85±2.21	7.92±2.34	>0.05	5.50±2.11	5.56±2.22	>0.05	102.20±20.10	103.60±22.70	>0.05
肌瘤剔除组	30	7.82±2.37	7.93±2.53	>0.05	5.47±2.31	5.83±2.42	>0.05	103.40±23.30	98.30±21.40	>0.05
全子宫切除组	30	7.93±2.25	16.23±4.25	<0.05	5.62±2.27	9.22±2.69	<0.05	101.60±22.70	58.00±16.20	<0.05

表2 3组患者术前及术后6个月激素水平变化比较(±s)

Table 2 Comparison of serum hormone levels among three groups 6 months after treatment(±s)

组别	n	FSH (mIU/mL)			LH(mIU/mL)			E₂(pg/mL)
组别	n	术前	术后6个月	P	术前	术后6个月	P	术前	术后6个月	P
HIFU组	30	7.85±2.21	7.92±2.34	>0.05	5.50±2.11	5.56±2.22	>0.05	102.20±20.10	103.60±22.70	>0.05
肌瘤剔除组	30	7.82±2.37	7.93±2.53	>0.05	5.47±2.31	5.83±2.42	>0.05	103.40±23.30	98.30±21.40	>0.05
全子宫切除组	30	7.93±2.25	16.23±4.25	<0.05	5.62±2.27	9.22±2.69	<0.05	101.60±22.70	58.00±16.20	<0.05

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