HEALTH OF WOMAN. 2020.8(154): 59–63; doi 10.15574/HW.2020.154.59
Ventskivska І., Proshchenko О., Vitovsky Ya., Markitanyuk S.
Bogomolets National Medical University, Kiev

Hysterectomy, performed in reproductive age, undoubtedly causes a decrease in all parameters of quality of life and contributes to the development of imbalance of hormonal homeostasis, psycho-emotional, vegetative-neurotic symptoms, increasing sexual and urogenital dysfunction, impeding psycho-social adaptation in the family,the professional and intellectual spheres of a woman’s life. This aspect is often overlooked by surgeons when evaluating the effectiveness of treatment, although it has a significant impact on recovery from surgery.
The article presents data on experimental psychological research, evaluation of the severity of urogenital dysfunction using a standardized POP-Q system, characteristics of quality of life parameters both at the stage of preoperative observation and within 1, 3 and 5 years after surgery in 80 women of reproductive age with uterine fibroids who have undergone vaginal hysterectomy. The comparison group included 60 patients with hysterectomy performed by abdominal access.
According to the results of this study, in women of reproductive age after radical surgery for fibroids, it was determined that the leading violations of quality of life after hysterectomy are general somatic symptoms, psycho-emotional disorders, genitourinary and sexual disorders. Radical operations for uterine fibroids cause an increase in the proportion of urogenital disorders, among which the most important are urinary incontinence and prolapse, the clinical manifestations of which have a negative impact on, including the psychosocial sphere, while reducing quality of life.
Today there is no consensus on the degree of impact of radical surgery for uterine fibroids on the versatility of metabolic and hormonal homeostasis, the formation of psychovegetative symptom complex, and as a consequence, the impact on quality of life, which necessitates a validated method of quality of life optimization of the rehabilitation program with personalized consideration of the leading factors of status comorbidity when planning surgical treatment.
Keywords: uterine fibroids, hysterectomy, quality of life parameters.

REFERENCES

1. Balan VE, Kovaleva LA. 2015. Urogenitalnyiy sindrom v klimakterii. Vozmozhnosti terapii. Akusherstvo i ginekologiya 5:104–108.

2. Ventegodt S. 2013. Kachestvo zhizni kak kriteriy effektivnosti lecheniya. Vestn. natsionalnogo mediko-hirurgicheskogo tsentra im. NI Pirogova 3;8:145.

3. Dobrohotova YuE. 2000. Psihoemotsionalnyiy i gormonalnyiy status zhenschin posle gisterektomii bez pridatkov. Ros. med. zhurn. 4:25–28.

4. Evstifeeva EA, Filippchenkova SI, Kalantarov TK, Holodin SP. 2016. Psihosomaticheskaya sostavlyayuschaya i kachestvo zhizni bolnyih hirurgicheskogo profilya. Arhiv' vnutrenney meditsinyi. Spetsialnyy vypusk: 61.

5. Zabolotnov VA, Karapetyan OV, Pamfamirov YuK, Pamfamirova GL, Kucherenko YuA, Tatevosyan AG. 2011. Sovremennyie vzglyadyi na etiologiyu, patogenez i lechenie miomyi matki. Zdorove zhenschinyi 5(61):15–20.

6. Zagorodnyaya ED, Barkan TM, Kolecnikov AD, Barkan VS, Rezanovich VS, Butunov AA, Tselyuba EA. 2013. Vliyanie gicterektomii na funktsiyu yaichnikov i kachectvo zhizni bolnyih miomoy matki. Akusherctvo i ginekologiya 2:48–81.

7. Savvina NV, Savvina AD i dr. 2013. Kachestvo zhizni kak pokazatel effektivnosti reabilitatsionnyh meropriyatiy. Vestn. natsionalnogo mediko-hirurgicheskogo tsentra im. NI Pirogova 8;3:41–43.

8. Kosenko NA, Tsyigankov BD, Kosenko VG i dr. 2014. Psihicheskie narusheniya pri endokrinopatiyah. Kubanskiy nauchnyiy meditsinskiy vestnik 148;6:107–114.

9. Lashkul OS. 2018. Kachestvo zhizni i seksualnaya funktsiya u zhenschin, operirovannyih na organah reproduktivnoy sistemyi. Zaporozhskiy meditsinskiy zhurnal 20;1(106):76–81.

10. Novikov AI, Mihaylichenko VV, Aleksandrov VP, Kurenkov AV i dr. 2008. Vliyanie operativnogo dostupa na funktsionalnoe sostoyanie nizhnih mochevyih putey pri gisterektomii. Andrologiya i genitalnaya hirurgiya 4:21–24.

11. Hanin YuL. 1976. Kratkoe rukovodstvo k shkale reaktivnoy i lichnostnoy trevozhnosti Ch.D. Spilbergera. L:18.

12. Vomvolaki E, Kalmantis K, Kioses E and Antsaklis A. 2006. The effect of hysterectomy on sexuality and psychological changes. The European Journal of Contraception and Reproductive Health Care March 11(1):23-27. https://doi.org/10.1080/13625180500430200; PMid:16546813

13. Stewart EA, Shuster LT, Rocca WA. 2012. Reassessing Hysterectomy. Minnesota Medicine. 95;3:36.

14. Kichigin RH, Arestova MI, Zanko SE. 2013. Risk factors for uterine fibroids and quality of life of patients operated on for uterine fibroids. Maternal and child health 2(22):36-41.

15. Makris N, Vomvolaki E, Partsinevelos G et al. 2006. The effect of hysterectomy on sexuality and psychological changes. The European Journal of Contraception and Reproductive Health Care March 11(1):23–27. https://doi.org/10.1080/13625180500430200; PMid:16546813

16. Roseske NC. 2007. Hysterectomy and other gynecological surgeries: a psychological view. Women’s place in medical and psychological interfaces 1:172–180.