Hysterectomy in reproductive age - pros and cons (Literature review)

Hysterectomy is one of the most frequently performed surgical interventions in the practice of an obstetrician-gynecologist. In recent decades the priority direction in the treatment of most diseases is the preservation or restoration of quality of life; and the scientific community has not ceased to discuss the consequences of hysterectomy for a female body. The purpose of this review is to summarize the literature data on the impact of uterine removal on a female body in reproductive age or perimenopause. The loss of the uterus, which is one of the main reproductive organs, has various negative effects, including psychological, social and physical aspects. At the same time, opinions on this issue are contradictory. Thus, some studies provide data on the fears in a number of patients about the loss of femininity, accompanied by insecurity, pessimism and depression. An important reason for preoperative anxiety in patients is concern about the impact of hysterectomy on sexual life. Indeed, hysterectomy can affect the anatomical structures of the pelvis, including regional innervation, leading to a decrease in sexual interest, arousal, and orgasm in approximately 15-20% of patients. At the same time, a significant number of sources indicate an improvement in the quality of life after hysterectomy, including sexual function. This is mainly due to the disappearance of symptoms of the disease that served as the basis for its implementation. The greatest concern is the effect of hysterectomy on the functional state of the ovaries. There is no doubt that most women do not lose ovarian function in the short term, namely, within the next year after hysterectomy. At the same time, most studies indicate that these women are at increased risk of premature ovarian failure in the future. Summary data obtained from the studied sources indicate that the hysterectomy has a number of negative effects on the female body. At the same time, the degree of these influences is relatively acceptable for surgical indications.