Efeitos da Histerectomia Total Abdominal sobre o Fluxo Sangüíneo Ovariano

Revista Brasileira de Ginecologia e Obstetrícia 01/2002; DOI: 10.1590/S0100-72032002000500007
Source: DOAJ

ABSTRACT Objetivo: avaliar os efeitos da histerectomia total abdominal (HTA) sobre o fluxo sangüíneo ovariano, em mulheres no menacme, por meio da dopplervelocimetria e ultra-sonografia transvaginal. Métodos: estudo prospectivo no qual foram incluídas 61 mulheres, com idade igual ou inferior a 40 anos. As pacientes foram divididas em dois grupos: G1, com 31 pacientes submetidas à HTA, e G2, com 30 mulheres normais não submetidas à cirurgia. Somente foram incluídas pacientes eumenorréicas, ovulatórias, não-obesas ou fumantes, sem cirurgias ou doenças ovarianas prévias. Avaliou-se o fluxo sangüíneo das artérias ovarianas, inicialmente e aos 6 e 12 meses, pelo índice de pulsatilidade (IP) na dopplervelocimetria, e o volume ovariano pela ultra-sonografia transvaginal (US). Para análise estatística empregou-se teste t pareado, análise de perfil, teste de Friedman e teste de Mann-Whitney. Resultados: na comparação estatística inicial os grupos foram homogêneos quanto às características epidemiológicas e quanto aos demais parâmetros avaliados neste estudo. Nas pacientes submetidas à histerectomia, observaram-se aos 6 e 12 meses aumento do volume ovariano ao US e diminuição do IP avaliado pela dopplervelocimetria (p<0,05), quando confrontadas ao controle. Aos 12 meses, em 8 das 31 pacientes pós-HTA (25,5%) verificou-se ocorrência de cistos ovarianos de aspecto benigno. No grupo controle não houve alteração de nenhum desses parâmetros. Conclusão: a redução do IP na dopplervelocimetria das artérias ovarianas sugere aumento do fluxo sangüíneo ovariano pós-histerectomia total abdominal em mulheres no menacme.

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