title: Change in the ovarian environment after hysterectomy with bilateral salpingectomy: is it the technique or surgery itself?
abstract: OBJECTIVE
  To compare the effects of total laparoscopic hysterectomy with bilateral salpingectomy (TLH-BS) and total abdominal hysterectomy with bilateral salpingectomy (TAH-BS) on ovarian function among women of reproductive age.
  
  
  METHODS
  One hundred and three patients with a diagnosis of benign uterine disorder were divided into two groups in this prospective longitudinal study. Patients who had never had sexual intercourse and patients with uterovaginal disproportion underwent TAH-BS (n=57), and the remaining patients (n=46) underwent TLH-BS. Ovarian function was assessed before and 6 months after surgery; ovarian volume was assessed by gray-scale ultrasonography, and levels of serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), oestradiol (E2), anti-Mullerian hormone (AMH) and inhibin B were measured.
  
  
  RESULTS
  Postoperative serum FSH, LH and inhibin B decreased significantly in both groups. Postoperative serum E2 did not change significantly. Postoperative serum AMH and ovarian volume decreased significantly in the TAH-BS group (p=0.016 and p<0.001, respectively), but not in the TLH-BS group. Significant differences were observed between the TLH-BS and TAH-BS groups with respect to change in FSH (p=0.012) and ovarian volume (p=0.001); between-group differences were not significant for changes in AMH and inhibin B.
  
  
  CONCLUSIONS
  Although serum AMH did not change significantly in patients who underwent TLH-BS, ovarian aging commenced following both surgical procedures.
authors: Department of Obstetrics and Gynaecology, Uludag University School of Medicine, Bursa, Turkey.
authors: M A
authors: MA
authors: Atalay
authors: Department of Obstetrics and Gynaecology, Uludag University School of Medicine, Bursa, Turkey. Electronic address: drbilgecd@gmail.com.
authors: B
authors: B
authors: Cetinkaya Demir
authors: Department of Obstetrics and Gynaecology, Uludag University School of Medicine, Bursa, Turkey.
authors: K
authors: K
authors: Ozerkan
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007044:Hysterectomy; D007265:Inhibins / Q000097:blood; D007986:Luteinizing Hormone / Q000097:blood; D008875:Middle Aged; D009929:Organ Size / Q000502:physiology; D010053:Ovary / Q000000981:diagnostic imaging*; D011184:Postoperative Period; D058994:Salpingectomy; D014591:Uterine Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: C422364:inhibin B; D004958:Estradiol; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone
keywords: Abdominal hysterectomy; Anti-Mullerian hormone; Laparoscopic hysterectomy; Ovarian function; Salpingectomy