子宫肌瘤手术时卵巢去留的问题

作者测定了因子宫肌瘤行子宫切除后5年以内的患者的卵巢功能,结果保留双侧卵巢者,卵巢功能正常,并能继续排卵。保留单侧卵巢10例中7例功能正常,2例无排卵,1例卵巢早衰。认为50岁以下,因肌瘤切除子宫时,应保留正常卵巢。保留双侧卵巢比单侧更好。凡卵巢与同侧输卵管均正常者,应当一并保留。

AN EVALUATION OF THE PRESERVATION OF OVARY DURING SURGERY FOR MYOMATA

This is a report of a follow-up studyon 327 cases of myoma treated with hyster-ectomy, 151 of whom had check-up examina-tions as well. Thirty-five women under 45 years ofage had the following examinations: basalbody temperature, vaginal cytology, and ra-dioimmunoassay for the estimation of serumestrogen and progesterone. A group of 7women of the same age with normal mens-truation has been used as control. Thepatients were divided into three groups: (1)conservation of both ovaries; (2) unilateraloophorectomy; and (3) bilateral oophorec-tomy. The hormonal characteristics of thewomen in group 1 and group 2 showed nodifference as compared with a controlgroup of the 7 normal women: in group 3the symptoms were the same as those inwomen with menopause. In the cases who had preservation ofboth ovaries after the operation and survivedfor five years or less, both ovarian functionand ovulation remained normal. In the 10cases with unilateral oophorectomy, 7 hadnormal function, 2 had anovulation and 1patient developed premature ovarian failure. The authors suggest that when a womanunder 50 years of age has menstruation atthe time of hysterectomy, her ovaries needto be preserved. It is, therefore, necessary to examinecarefully during the operation, by mean ofsection and biopsy of the ovary if malig-nancy is suspected. The postoperative resultwill be better if both ovaries are saved.When an ovary and ipsilateral tube arenormal they should be left alone.