Does Type of Hysterectomy Affect the Ovarian Function?
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Various types of hysterectomy have been studied and compared by different authors. Total abdominal hysterectomy (TAH), laparoscopic hysterectomy, radical hysterectomy, and subtotal hysterectomy have all shown varying degrees of ovarian function compromise.

Moorman et al. reported that the risk of ovarian failure was higher for women who had a unilateral oophorectomy along with their hysterectomy as compared to women who had a hysterectomy with both ovaries left intact. One study compared subtotal hysterectomy by laparoscopy and laparotomy and found that laparoscopic subtotal hysterectomy is associated with lower rates of loss of ovarian function. The risk of early menopause is lower in women undergoing subtotal hysterectomy compared to total hysterectomy. Ishii et al. studied ovarian function after radical hysterectomy with ovarian preservation for cervical cancer. While cancer risk did not increase in this study, 15 of 33 patients became menopausal after treatment. There was a significant correlation with the age of radical hysterectomy. The younger the patient, the better was the ovarian function preservation.

Ovarian transposition is often used before radical hysterectomy and radiotherapy. Gubbala et al. concluded in their review that ovarian transposition is associated with 90% preservation of ovarian function and negligible risk of metastases to the transposed ovaries despite the common incidence of ovarian cysts. The preservation of ovarian function dropped to 65% when external radiation was used postoperatively. They encouraged its use for younger women to preserve ovarian function.

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