Comparison of 550 cases of surgical and natural menopause in respect to Genito-urinary Syndrome of Menopause (GSM)

Nusrat Mahjabeen, Sk. Zinnat Ara Nasreen
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Abstract

Natural menopause and surgical menopause are used interchangeably when conditions of patients are discussed. But they are different entirely. One is a natural stage of life that all women experience, the other is the result of surgery. This prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Z.H. Sikder Women’s Medical College & Hospital, Dhaka from January 2016 to December 2018 over a period of three years to compare the GSM effects in natural and surgical menopause cases. During the study period a total of 275 patients with surgical menopause and 275 patients with natural menopause were enrolled employing purposive sampling method using a predesigned data collection sheet. Age of the most of the patients in surgical menopause group was within 41 to 50 years and most of the patients were >50 years old in natural menopause group. Most of the patients were illiterate in both groups and maximum patients were poor in both groups. Hot flush (48.0% vs 28.0%), dryness of vagina (12.0% vs 0.0%) and dyspareunia (72.0% vs 28.0%) were found significantly higher in surgical menopause than natural menopause. Dysuria (92.0% vs 40.0%) and increased frequency of urination (68.0% vs 36.0%) were significantly higher in surgical menopause than natural menopause group. Urgency, hesitancy and incontinence of urination were significantly lower (p=<0.001) in surgical menopause than natural menopause group. In most of the surgical menopause cases, ovaries were also sacrificed. And this may be the reason of more deleterious effects in surgical menopause than natural menopause. So, it is highly recommended to preserve ovaries in hysterectomies due to benign indications.
550例手术绝经与自然绝经的泌尿生殖综合征比较
自然绝经和手术绝经是交替使用时,病人的条件进行讨论。但它们是完全不同的。一个是所有女性都会经历的自然阶段,另一个是手术的结果。这项前瞻性观察性研究于2016年1月至2018年12月在达卡Z.H. Sikder妇女医学院和医院妇产科进行,为期三年,比较GSM在自然和手术绝经病例中的效果。在研究期间,采用目的抽样方法,采用预先设计的数据收集表,共入组275例手术绝经患者和275例自然绝经患者。手术绝经组患者年龄以41 ~ 50岁为主,自然绝经组患者年龄以>50岁为主。两组患者中文盲居多,穷人居多。手术绝经的潮热(48.0%比28.0%)、阴道干燥(12.0%比0.0%)和性交困难(72.0%比28.0%)明显高于自然绝经。手术绝经组排尿困难(92.0% vs 40.0%)和排尿频率增加(68.0% vs 36.0%)明显高于自然绝经组。手术绝经组尿急、犹豫、尿失禁明显低于自然绝经组(p=<0.001)。在大多数手术绝经病例中,卵巢也被切除。这可能是手术绝经比自然绝经更有害的原因。因此,由于良性适应症,强烈建议在子宫切除术中保留卵巢。
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