The impact of hysterectomy for benign uterine tumors on subsequent ovarian reserve, lower urinary tract symptoms, and sexual function: A prospective multidirectional short-term analysis.

Abstract

Objective: To evaluate the effects of hysterectomy for benign uterine tumors on subsequent ovarian reserve, sexual function, and lower urinary tract symptoms (LUTS).

Methods: The present study was a prospective longitudinal analysis that recruited patients aged 35-45 years who underwent simple hysterectomy without oophorectomy for symptomatic benign uterine tumors. Anti-Müllerian hormone (AMH) and serum sex hormone profiles, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, and total testosterone, were measured at four timepoints: before hysterectomy, and 3, 6, and 12 months postoperatively. Participants completed the following questionnaires at these timepoints: Urinary Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), and Pelvic Organ Prolapse/Urinary Incontinence and Sexual Function Questionnaire (PISQ-12) short form.

Results: A total of 36 patients completed the study. Serum AMH levels significantly declined post-hysterectomy compared with preoperative levels. Both UDI-6 and IIQ-7 scores significantly decreased post-hysterectomy compared with preoperative scores. No differences were observed in serum FSH, LH, estradiol, progesterone, and testosterone levels before and after hysterectomy. No significant differences were found in the short form of PISQ-12 before and after hysterectomy.

Conclusion: The present study demonstrated that simple hysterectomy with ovarian preservation had detrimental effects on ovarian reserves, whereas LUTS showed improvement. Furthermore, sexual dysfunction was not likely to occur within the first postoperative year.