Endocrinological and statistical analysis of ovarian function in hysterectomized patients Masaya HAYAFUJI, Kazuaki KATAYAMA and Matsuto MOCHIZUKI Depa

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1 Endocrinological and statistical analysis of ovarian function in hysterectomized patients Masaya HAYAFUJI, Kazuaki KATAYAMA and Matsuto MOCHIZUKI Department of Obstetrics and Gynecology, Kobe University School of Medicine, Kobe (Director:Prof. Matsuto Mochizuki) Function of the ovaries which were preserved at the time of hysterectomy was analized in 151 patients by the post-operative patterns of basal body temperature(bbt), the serum levels of FSH, LH and estradiol(e2)and the pre-and post-operative scores of Kupperman's index. Ovarian endocrinological function was completely maintained in almost all patients in whom bilateral ovaries and tubes had been preserved. But in some patients with unilateral ovary with or without tube, ovarian function was extremely damaged with increased gonadotropins and decreased estrogen. Incidence of damaged ovary was much higher in the group of patients without tube than that in the group of patients with tube. Incidence of hot flash or other symptoms and scores of Kupperman's index were highest in the group of patients without ovary, and lowest in the group with bilateral ovaries with tubes. But, even in endocrinologically normal patients with bilateral ovaries with tubes, the incidence of those symptoms in post-operative period were significantly higher than that in pre-operative period. These results suggest that hot flash or other climacteric disorder like symptoms in post-operative period are not always due to the cease of endocrinological function of the ovary but also due to the psychological effect of the operation to the patients. From results above mentioned, it was concluded that in order to maintain the endocrinological ovarian function, it is better to preserve bilateral ovaries including tubes at the time of hysterectomy and that pre-operative plain explanation about the operation to patients is extremely important to reduce the post-operative symptoms. Key words:ovarian function, hysterectomy, basal body temperature (BBT), Kupperman's index, hot flash

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12 8) Beling, C. G. et al.:functional activity of the corpus luteum following hysterectomy, J. Clin. Endocri., 30:30, ) Doyle, L. L. et al.:human luteal function following hysterectomy as assessed by plasma progestin, Am. J. Obstet. Gynecol., 110:92, ) Grodin, J. M. et al.:source of estrogen p- oduction in postmenopausal women, J. Clin. Endocri. Metab., 36:207, ) Janson, P. O. and Jansson, I.:The acute effect of hysterectomy on ovarian blood flow, Am. J. Obstet. Gynecol., 127:349, ) Kupperman, H.S. et al.:comparative clinical evaluation of estrogenic preparations by the menopausal and amenorrheal indices, J Clin. Endocri. Metab., 13:688, ) Pharris, B. B. et al.:prostaglandins in luteal function, Rec. Progr. Hormone. Res., 28:51, ) Ranney, B, and Abu-Ghazalen, S.:The future function and fortune of ovarian tissue which is retained in vivo during hysterectomy, Am. J. Obstet. Gynecol., 128:626, ) Richards, N. A.:The surgical menopause following hysterectomy, Proceedings of the Royal Society of Medicine, 44:496, ) Richards, D. H.:A post-hysterectomy syndrome, the lancet oct., 26:983, ) Sessums, J. V. and Murphy, D. P.:Hysterectomy and the artificial menopause, Surg. Gynecol. Obstet., 55:286, ) Whitelaw, R. G.:Ovarian activity following hysterectomy, J. Obstet. and Gynecol. Brit. Emp., 65:917, 1958.

1 ) Birnberg et al; Am. J. Obst. Gyn., 54 :88E 1947. 2) Bromberg, Y.M. & Bercovici, B. : Acta Endocrin., 7; 71, 1956. 23 : 33, 1956; Fertil. and Steril. 3) Fluhmann, C. F. : The management of menstrual

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