Study on the Change in Function of the Preserved Ovaries following Hysterectomy by Abdominal Versus Vaginal Route

Objectives: Our primary objective was to study any change in ovarian blood flow in the preserved ovaries following hysterectomy either by abdominal (AH) or vaginal route (VH). Our secondary objectives were to study menopausal symptoms and change in hormonal parameters postoperatively in these two types of hysterectomy. Materials and methods: This prospective observational study was conducted in the departments of obstetrics and gynecology and radiology of Medical College Hospital, Kolkata. 90 patients undergoing hysterectomy with ovarian preservation - 42 by abdominal route(AH group) and 48 by vaginal route (VH group) were studied on 5th postoperative day and 6th postoperative month in terms of ovarian arterial doppler indices and clinical and hormonal changes suggestive of menopause and compared these postoperative parameters with the preoperative parameters. Results: There was statistically significant decrease in Vmax and PI at 5th day and 6th month in ovaries in both the groups. The reduction was greater at 6th postoperative month in VH group as compared to AH group. There was statistically significant increase in menopausal symptoms in VH group and serum FSH and LH level at 6th postoperative month, but no difference in these parameters between groups. Conclusion: Menopausal symptoms are more in VH group as compared to AH group due to reduced Vmax and PI in ovarian arteries in preserved ovaries as early as 6 months postoperatively.