Effect of hysterectomy with opportunistic salpingectomy for uterine fibroids on the development of metabolic syndrome and ways of its reduction

Abstract

The aim of the study – to determine the effect of hysterectomy with opportunistic salpingectomy for uterine fibroids on the manifestation and progression of metabolic syndrome and to develop ways of reducing the identified changes. Materials and Methods. A comprehensive clinical and laboratory evaluation of the influence of hysterectomy with opportunistic salpingectomy for uterine fibroids on the development of metabolic syndrome was performed in the Gynecological Department of Municipal Non-Profit Enterprise “Kyiv Perinatal Center”. 160 women were included in the study: 90 patients underwent vaginal hysterectomy including fallopian tubes (both classical and associated with laparoscopy), and 70 women underwent abdominal hysterectomy including fallopian tubes. Results and Discussion. The development and progression of hypoestrogenemia after hysterectomy with opportunistic salpingectomy contributes to the loss of cardioprotective effects of estrogen, accompanied by psychoemotional and vegetative-vascular dystonia in the early postoperative period of mild and moderate degree, mostly in women under 45 years (30.63 % and 71.86 %, respectively), while metabolic and endocrine abnormalities are practically absent. At the same time, 12 months after surgery, 56.9 % of patients undergo gradual formation of the main components of the metabolic syndrome – hyperglycemia, insulin resistance, dyslipidemia, increasing parameters of atherogenic lipid fractions, increased BMI and vegetative dystonia of the hypertensive type. Conclusions. The use of metabolic therapy in the remote postoperative period allowed to control blood pressure and improve the clinical and laboratory parameters, namely reducing the level of atherogenicity index by 1.3 times (p<0.05), glycated hemoglobin, OGTT, HOMA index – by 0.8 times against baseline before treatment, which was accompanied by improvement of psycho-emotional and vegetative-vascular manifestations.