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The study compares the effect of bilateral salpingectomy associated with conservative hysterectomy on ovarian function to the standard hysterectomy with conservation of both ovaries and tubes in terms of hormone assays, ovarian ultrasound evaluation, complications, quality of life.
Hysterectomy is one of the most common gynecologic procedures performed in clinical practice. In this study we focused on non menopausal patients under 52 years having hysterectomies for benign disease : uterine leiomyomas, adenomyosis, endometriosis, dysfunctional uterine bleeding, genital prolapse, cervical dysplasia... with failure of conservative treatment.
the standard procedure during hysterectomy with conservation of the ovaries has been the preservation of fallopian tubes with the clamps placed as close to the uterine corpus as possible. this is suggested to decrease interference with the vascular structures in the mesosalpinx and mesovarium. however it is unclear whether tubal conservation at the time of hysterectomy has any influence on ovarian blood flow or ovarian reserve. another point to be considered is the occurrence of post-hysterectomy carcinoma in the preserved fallopian tube, theoretically, these cases could be prevented if tubal excision is performed during hysterectomy The study compares the effect of bilateral salpingectomy associated with conservative hysterectomy on ovarian function to the standard hysterectomy with conservation of both ovaries and tubes in terms of hormone assays, ovarian ultrasound evaluation, complications, quality of life.
impact of treatments on ovarian reserve are tested by measuring AMH at baseline and 3 days, 6 weeks and 6, 12 months after surgeries.
quality of life is also assessed at these time points, with a questionnaire (Women Health Questionnaire WHQ).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| conservative hysterectomy I | Experimental | bilateral salpingectomy during hysterectomy with conservation of the ovaries |
|
| conservative hysterectomy II | Active Comparator | standard conservative hysterectomy with conservation of both ovaries and tubes |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| conservative hysterectomy I | Procedure | conservative hysterectomy for benign disease |
|
| Measure | Description | Time Frame |
|---|---|---|
| percentage of patients with more than 20% diminution of AMH logarithm at one year (12 months) | one year |
| Measure | Description | Time Frame |
|---|---|---|
| AMH measurement at 3 days, 6 weeks, and 6, 12 months after hysterectomy endovaginal ultrasound evaluation of the ovarian volume and vascularisation quality of life (WHQ questionnaire) reintervention procedures complications | day3, week 6, month 6 and month 12 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Lobna OULDAMER, MD | CHRU de TOURS | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU | Angers | 49933 | France | |||
| CHU |
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| Conservative hysterectomy II | Procedure | bilateral salpingectomy during hysterectomy without conservation of the ovaries |
|
| Le Kremlin-Bicêtre |
| 94 275 |
| France |
| CHU | Lille | 59 037 | France |
| Hôpital Sud | Lyon | 69495 | France |
| CHU | Poitiers | 86000 | France |
| CHU | Rennes | 35203 | France |
| CHU | Tours | 37044 | France |
| ID | Term |
|---|---|
| D005831 | Genital Diseases, Female |
| D062788 | Adenomyosis |
| D004715 | Endometriosis |
| D008796 | Metrorrhagia |
| D002578 | Uterine Cervical Dysplasia |
| D014596 | Uterine Prolapse |
| ID | Term |
|---|---|
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D000091662 | Genital Diseases |
| D014591 | Uterine Diseases |
| D014592 | Uterine Hemorrhage |
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D011230 | Precancerous Conditions |
| D009369 | Neoplasms |
| D002577 | Uterine Cervical Diseases |
| D056887 | Pelvic Organ Prolapse |
| D011391 | Prolapse |
| D020763 | Pathological Conditions, Anatomical |
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