EFEITOS DA HISTERECTOMIA TOTAL ABDOMINAL SOBRE O FLUXO SANGUINEO OVARIANO EM MULHERES NO MENACME

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aguiar9.jpg Autor:
Eliana Aguiar petri nahas
Columnista Experto de SIIC
Artículos publicados por Eliana Aguiar petri nahas
Coautor
Anaglória Pontes (Professora Doutora), Paulo* 
Faculdade de Medicina de Botucatu – UNES*
Recepción del artículo
16 de Octubre, 2003
Primera edición
12 de Enero, 2004
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Objetivo. Avaliar os efeitos da histerectomia total abdominal (HTA) sobre o fluxo sangüíneo ovariano, em mulheres no menacme, por meio da dopplervelocimetria e ultra-sonografia transvaginal. Pacientes e Métodos. Estudou-se, prospectivamente, 61 mulheres, 40 anos, divididas em: G1, 31 pacientes submetidas à HTA e, G2, 30 mulheres normais. Critérios de inclusão: eumenorreicas, ovulatórias, não obesas ou fumantes, sem cirurgias ou patologias ovarianas prévias. Avaliou-se o fluxo sangüíneo das artérias ovarianas, inicialmente e aos 6 e 12 meses, pelo índice de pulsatilidade (IP) na dopplervelocimetria e o volume ovariano pela ultra-sonografia transvaginal (US). Para análise estatística empregou-se Teste t de Student, Análise de Perfil, Teste de Friedman e Teste de Mann-Whitney. Resultados. Na comparação estatística inicial os grupos foram homogêneos. Nas pacientes submetidas à histerectomia, aos 6 e 12 meses, observou-se aumento do volume ovariano ao US e diminuição do IP ao doppler (p<0,05), quando confrontadas ao controle. Aos 12 meses, em 8 das 31 pacientes pós HTA (25,5%) verificou-se cistos ovarianos, de aspectos benignos. No grupo controle não alterou nenhum desses parâmetros. Conclusão. A redução do índice de pulsatilidade na doplervelocimetria das artérias ovarianas sugere aumento do fluxo sangüíneo ovariano pós histerectomia total abdominal em mulheres no menacme.

Palabras clave
Histerectomia Total Abdominal; Ultra-sonograf


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Abstract
Objective: To evaluate the effect of total abdominal hysterectomy on ovarian blood supply in women of reproductive age, using transvaginal color doppler.Patients and Methods: A prospective study on 61 women, age 40 years, was distributed in: G1, 31 patients submitted to hysterectomy and, G2, 30 normal women. Criteria of inclusion: normal ovarian function at baseline, normal body weight, without tobacco exposition, no history laparotomy or ovarian pathology. The Pulsatility Index (PI) realized by the doppler of ovarian arteries and the ultrasonography transvaginal measures of the ovarian volume were performed in 3 moments: baseline, 6 and 12 months.Results: At baseline the groups were homogeneous. In the patient hysterectomized group, with 6 and 12 months, it was observed increase of the volume of the ovaries and decrease of PI (p<0,05). At the end of the study, among the patient hyterectomized, 25,5% (8/31) of them presented benign ovarian cysts. While in the control group it was not observed alteration of any appraised parameter.Conclusion: The decrease of Pulsatility Index by the doppler of ovarian arteries suggest increased ovarian blood supply after total abdominal hysterectomy in women of reproductive age.

Key words
Total Abdominal Hysterectomy; Ultrasonography


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Especialidades
Principal: Obstetricia y Ginecología
Relacionadas: Medicina Interna



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Bibliografía del artículo
  1. Dekel A, Efrat Z, Orvieto R, Levy T, Dicker D, Gal R, Ben-Rafael Z. The residual ovary syndrome: a 20-year experience. Eur J Obstet Gynecol Reprod Biol 1996;68:159-64.
  2. Fong YF, Lim FK, Arulkumaran S. Prophylactic oophorectomy: a continuing controversy. Obstet Gynecol Surv 1998;53:493-9.
  3. Reich H. Issues surrounding surgical menopause. J Reprod Med 2001;46:297-306.
  4. Laughlin GA, Barrtt-Connor E, Silverstein D, von Mühlen D. Hysterectomy, oophoectomy, and endogenous Sex hormone levels in older women: The Rancho Bernardo Study. J Clin Endocrinol Metab 2000;85:645-51.
  5. Parazzini F, Negri E, Vecchia C, Luchini L, Mazzopane R. Hysterectomy, oophorectomy, and subsequent ovarian cancer risk. Obstet Gynecol 1993;81:363-6.
  6. Beard CM, Hartmann LC, Atkinson EJ, O'Brien PC, Malkasian GD, Keeney GL, Melton LJ. The epidemiology of ovarian cancer: a population-based study in Olmsted County, Minnesota, 1935-1991. Ann Epidemiol 2000;10:14-23.
  7. Chalmers C. Does hysterectomy in premenopausal woman affect ovarian function Med Hypotheses 1996;46:573-5.
  8. Borell U, Fernström I. The adnexal branches of the uterine artery. Acta Radiol 1953;40:561-82.
  9. Janson PO, Jansson I. The acute effect of hysterectomy on ovarian blood flow. Am J Obstet Gynecol 1977;127:349-52.
  10. Souza AZ, Fonseca AM, Izzo VM, Clauzet RM, Salvatore CA. Ovarian hystology and function after total abdominal hysterectomy. Obstet Gynecol 1986;68:847-9.
  11. Siddle N, Sarrel P, Whitehead M. The effect of hysterectomy on the age at ovarian failure: identification of a subgroup of women with premature loss of ovarian function and literature review. Fertil Steril 1987;47:94-100.
  12. Hata K, Hata T, Senoh D, Makihara K, Aoki S, Takamiya O, Kitao M. Change in ovarian arterial compliance during the human menstrual cycle assessed by doppler ultrasound. Br J Obstet Gynaecol 1990;97:163-6.
  13. Tinkanen H, Kujansuu E, Laippala P. The association between hormone levels and vascular resistance in uterine and ovarian arteries in spontaneous menstrual cycles- a doppler ultrasound study. Acta Obstet Gynecol Scand 1995;74:297-301.
  14. Tan SL, Zaidi J, Campbell S, Doyle P, Collins W. Blood flow changes in the ovarian and uterine arteries during the normal menstrual cycle. Am J Obstet Gynecol 1996;175:625-31.
  15. Kurjac A, Kupesic S. Ovarian senescence and its significance on uterine and ovarian perfusion. Fertil Steril 1995;64:532-7.
  16. Serafini P, Batzofin J. Transvaginal color doppler ultrasonography in reproductive gynecology. Int J Fertil 1994;39:253-61.
  17. Prömpeler HJ, Madjar H, Sauerbrei W. Classification of adnexal tumors by transvaginal color doppler. Gynecol Oncol 1996;61:354-63.
  18. Dogan MM, Basaran Z, Ekici E, Basaran O, Özcan T, Gökay Z, Gökmen O. Effect of hysterectomy on ovarian blood supply and function. J Obstet Gynaecol 1998;18:263-6.
  19. Bhattacharya S, Mollison J, Pinion S, Parkin DE, Abramovich DR, Terry P, Kitchener HC. A comparison of bladder and ovarian function two years following hysterectomy or endometrial ablation. Br J Obstet Gynaecol 1996;103:898-903.
  20. Pavlik EJ, DePriest PD, Gallion HH, Ueland FR, Reedy MB, Kryscio RJ, vanNagell JR. Ovarian volume related to age. Gynecol Oncol 2000;77:410-2.
  21. Grogan RH. Reappraisal of residual ovaries. Curr Opin Obstet Gynecol 1967;97:124-9.
  22. Richlin SS, Rock JA. Ovarian remnamnt syndrome. Gynaecol Endoscopy 2001;10:111-7.
  23. Menon RK, Okonofua FE, Agnew JE, Thomas M, Bell J, OBrein PMS, Dandona P. Endocrine and metabolic effects of simple hysterectomy. Int J Gynaecol Obstet 1987;25:459-63.
  24. Zalel Y, Lurie S, Beyth Y, Goldberger S, Tepper R. Is it necessary to perform a prophylactic oophorectomy during hysterectomy Eur J Obstet Gynaecol Reprod Biol 1997;73:67-70.
  25. Pete I, Bõsze P. The fate of the retained ovaries following radical hysterectomy. Eur J Gynaecol Oncol 1998;19:22-4.

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