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

[1]	Yue J, ed.Obstetrics and gynecology.7th ed[M].Beijing:People's Medical Publishing House, 2008: 269.
[2]	Tu J, Liu M.Clinical application on the treatment of uterine hysteromyomas using high-intensity focused ultrasound[J]. China Med Herald, 2009:35.
[3]	Zhang Y, Yang WW, Li J, et al.The clinical study on single treatment of uterine leiomyoma by high intensity focused ultrasound[J]. Chin J Med Ultrasound:Electron ed, 2009, 6(1):66-72.
[4]	Leeper K, Garcia R, Swisher E, et al. Pathologic findings in prophylactic ophorectomy specimens in high-risk women[J].Gynecol Oncol, 2002, 87:52.
[5]	Basu A, Devara JS, Jialal I, et al.Dietary factors that promote or retard inflammation[J].Arterioscler Thromb Vasc Biol, 2006, 26(5):995-1001.
[6]	Li J, Lu Q. Analysis of clinical long and short term complications of total abdominal hysterectomy:236 cases[J].Chin J Pract Gynecol Obstet, 2003, 19(21):53.

[1]	Hui Li, Qi Wu, Ziqi Zhang, Han Zhang, Fang Wang, Peng Xu. Early-stage clinical outcome of outpatient total knee arthroplasty and standard process exploring[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(06): 889-892.
[2]	Zhe Yi, Zhixin Wang, Wei Chen, Weiya Qi, Jie Fang, Haifei Shi, Xia Zhao, Zhe Zhao, Feng Zhu, Wei Sheng, Yan Chen, Yuhao Zhang, Jin Zhu, Yaobin Yin, Yong Yang, Shanlin Chen, Bo Liu. Surgical operation specifications for robot-assisted percutaneous fixation of non-displaced acute scaphoid fracture[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2023, 18(06): 464-468.
[3]	Liwen Hao, Zengtao Wang, Kai Rong, Zhidian Hou, Chao Chen, Shenqiang Qiu, Linfeng Liu, Di Zhang, Yunpeng Wang, Shuo Zhong. Observation on the application effect of great toe widening surgery in full-shaped reconstruction of defective fingers[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2023, 18(06): 476-479.
[4]	Shenqiang Qiu, Zengtao Wang, Liwen Hao, Chao Chen, Linfeng Liu, Di Zhang. Observation on the effect of the second stage plastic surgery for full-shaped reconstruction of thumb and fingers[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2023, 18(06): 485-490.
[5]	Wei Zhang. Dentoalveolar surgery: The pioneer of comfortable treatment[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2023, 17(06): 386-388.
[6]	Chen Yi, Yadong Zhang, Qian Dong, Haikuo Tang, Zhiguo Liu. Clinical outcome of bone lid technique in the extraction of the deeply impacted mandibular third molar[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2023, 17(06): 424-429.
[7]	Yadong Zhang, Chen Yi, Xiangqi Liu, Jiashun Wu, Qian Dong, Zhiguo Liu, Haikuo Tang. Analysis of the application of coronectomy in the treatment of mandibular impacted third molars[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2023, 17(06): 436-440.
[8]	Li Dai, Huiwei Deng, Huajing Guo, Furong Huang. Effect of continuous infusion of esketamine on postoperative sleep quality of patients undergoing laparoscopic colorectal cancer surgery[J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(06): 408-412.
[9]	Xuyuan Chen, Shiyun Luo, Wenzhong Li, Yi Li. Analysis of risk factors for wound healing difficulties after operative treatment of adenogenic anal fistula[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 82-85.
[10]	Kailun Ji, Shaolong Hao, Haitao Sun, Wei Han. New progress of gallstone formation mechanism after weight loss[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 100-103.
[11]	Qian Yang, Cuifang Li, Wanqiu Zhang. Analysis of short-term and long-term prognosis and influencing factors of primary liver cancer with spontaneous ruptured hemorrhage after emergency TACE surgery[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 33-36.
[12]	Bo Mo, Pei Wang, Heng Wang, Zhijun He, Jun Liang, Zhinan Hao. Curative effect of laparoscopic radical gastrectomy and modified radical gastrectomy for early gastric cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 644-647.
[13]	Yuegang Liu, Zhenfeng Xue. Safety analysis of laparoscopic inguinal hernia day surgery in the elderly[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(06): 711-714.
[14]	Yongsheng Li, Jiahe Sun, Shuwei Guo, Yikang Lu, Hongzhou Liu. Short-term postoperative complications and their influencing factors in elderly patients with colorectal cancer[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(9): 962-967.
[15]	Jing Li, Lingling Zhang, Wei Xing. Value of concept of interest induction before anesthesia induction in pediatric surgery and its effect on family satisfaction[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(07): 812-817.

Viewed

Full text

Abstract

Please choose a citation manager

Content to export