Changes in ovarian function and prevalence of menopausal symptoms after hysterectomy for pelvic organ prolapse in women of reproductive age

Objective: To study the effect of hysterectomy for pelvic organ prolapse on ovarian reserve and the prevalence of menopausal symptoms in women of reproductive age. Material and methods: The study was conducted before surgical treatment, and then one hour and two years after it in two groups of women. The main group included 48 patients whose surgical treatment consisted of hysterectomy. Organ-preserving surgical technologies were used in the comparison group, consisting of 51 women. The state of the ovarian reserve was assessed by the content of anti-Müllerian hormone in the blood serum. Kupperman menopausal index was used to study the frequency of menopausal disorders. Results: Before surgery, the differences in the studied parameters in patients of the main and the comparison groups were statistically insignificant. One year after the surgery, a statistically significant excess of the number of women with a decrease of anti-Müllerian hormone level and the rate of its decrease was established in the main group. At the same time, the groups did not differ in the number of patients with the lower threshold value of this indicator. The negative effect of hysterectomy on the state of the ovarian reserve was also not realized in the form of an increase in the frequency of climacteric disorders. Two years after the surgery, the rates of decrease in the content of anti-Müllerian hormone in the groups were equal. Nevertheless, the high rates of decrease in hormone levels in women of the main group, revealed in the study conducted in the previous period, led to statistically significant differences in the number of patients with its minimum threshold value. The absolute risk of climacteric syndrome in them was 2 times higher than that of its natural decrease associated with age-related changes. Conclusions: Damage to the ovaries caused by the hysterectomy and manifested in a decrease in the ovarian reserve and an increase in the frequency of climacteric disorders occurs immediately after the surgery. At the same time, the implementation of these damages is gradual and manifests in the remote period of observation.