Cerrahi menapozun kadınlarda vasomotor semptomlar ve anksiyete üzerine etkisi: Prospektif çalışma

Öz

Amaç: Bu çalışmada perimenopozal dönemde total abdominal histerektomi ve bilateral salpenjektomi (TAH+BS) yapılan hastalar ile total abdominal histerektomi ve birlikte bilateral salpingooferektomi (TAH+BSO) yapılan hastaların postoperatif kontrollerinde vasomotor semptomları ve ruhsal durumları arasındaki farklılıkları tespit etmek amaçlandı. Gereç ve Yöntem: Çalışma prospektif olarak dizayn edildi. Benign endikasyonlarla perimenopozal dönemde TAH+BS yapılan ve TAH+BSO yapılan kadınlar çalışmaya dahil edildi. Ameliyattan üç ay sonra menopoz semptomları (vazomotor semptomlar, vajinal kuruluk ve/veya disparoni, hafıza ve uyku sorunları gibi) araştırıldı. Ameliyattan bir gün önce ve ameliyattan üç ay sonra Beck Anksiyete Ölçeği (BAÖ) skorları incelendi. Bulgular: 51 hastaya TAH+BS ve 55 hastaya TAH+BSO yapıldı. Vazomotor semptomlar ve postoperatif BAÖ skoru ooferektomi yapılan grupta anlamlı yüksek bulundu (sırasıyla p<0.001 ve p=0.009). Cinsel fonksiyonu olumsuz etkileyen vajinal kuruluk ve/veya disparoni ooferektomi yapılan grupta anlamlı olarak daha yüksek saptandı (p=0.005). Hafıza ve uyku problemleri ooferektomi yapılan grupta daha yüksekti (sırasıyla p=0.009 ve p<0.001). TAH+BSO grubunda postmenopozal semptomlar (vazomotor semptomlar, vajinal kuruluk ve/veya disparoni, hafıza problemleri, uyku bozuklukları) ile postoperatif BAI skorları arasında korelasyon saptandı. Sonuç: Histerektomi ile birlikte bilateral salpingooferektomi yapılan hastalarda vazomotor semptomlar, vajinal kuruluk ve/veya disparoni, hafıza ve uyku sorunları ve anksiyete düzeyleri sadece histerektomi ile bilateral salpenjektomi yapılan hastalara göre anlamlı derecede yüksektir. Operasyon planlanan olguların ooferektomi kararı öncesi bu etkiler açısından bilgilendirilmesi faydalı görünmektedir.

Anahtar Kelimeler

• Histerektomi
• Ooferektomi
• Menopoz
• Seksüel Disfonksiyon

The Effect of Surgical Menopause on Vasomotor Symptoms and Anxiety in Women: A Prospective Study

Abstract

Aim: To investigate the effect of of adding oophorectomy on patients who underwent abdominal hysterectomy in the perimenopausal period on menopause, sexual function and mental status.
Materials and Methods: The study was designed prospectively. Women who underwent total abdominal hysterectomy and bilateral salpingectomy (TAH+BS) and total abdominal hysterectomy and bilateral salpingo-ophorectomy (TAH+BSO) in the perimenopausal period for benign indications were included in the study. Three months after surgery, menopausal symptoms (such as vasomotor symptoms, vaginal dryness and/or dyspareunia, memory and sleep problems) were investigated. Beck Anxiety Inventory (BAI) scores were investigated one day before the operation and three months after the operation.
Results: 51 patients with TAH+BS and 55 patients with TAH+BSO included in study. Vasomotor symptoms and postoperative BAI scores were significantly higher in the oophorectomy group (p<0.001 and p=0.009, respectively). Vaginal dryness and/or dyspareunia, which adversely affect sexual function, were significantly higher in the oophorectomy group (p=0.005). Memory and sleep problems were higher in the oophorectomy group (p=0.009 and p<0.001, respectively). Postoperative BAI scores were found to be correlated with postmenopausal symptoms (vasomotor symptoms, vaginal dryness and/or dyspareunia, memory problems, sleeping disorders) in the TAH+BSO group.
Conclusion: Vasomotor symptoms, vaginal dryness and/or dyspareunia, memory and sleeping problems, and anxiety levels were significantly higher in patients who underwent bilateral salpingo-ophorectomy with hysterectomy compared to patients who underwent only hysterectomy and bilateral salpingectomy. It seems useful to inform the patients who are planned for the operation regarding these effects before the decision of oophorectomy.

Keywords

• Hysterectomy
• Oopherectomy
• Menopause
• Sexual Dysfunction

Kaynakça

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