Browsing by Author "Lietuviete, Nellija"

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    Quality of female sexual function after conventional abdominal hysterectomy - three months' observation
    (2014-11-24) Briedīte, Ieva; Ancāne, Gunta; Rogovska, Irēna; Lietuviete, Nellija; Department of Obstetrics and Gynaecology; Department of Psychosomatic Medicine and Psychotherapy; Department of Doctoral Studies
    Introduction. Many medical and conservative surgical treatment options are available but still hysterectomy remains the most common gynecological procedure performed worldwide. These procedures are performed because of actual and possible malignant diseases, and benign conditions including pelvic pain, dyspareunia, uterine myomas, adenomyosis, endometriosis, and menometrorrhagia. The impact of hysterectomy on sexual function has always been a great concern to women and is a major source of preoperative anxiety. Data regarding the impact of hysterectomy on women’s sexual functioning are not clear and consistent, many women report improvement of sexual functioning after hysterectomy, which may be due to relief of symptoms, while others complain of sexual dysfunction as a result of hysterectomy. Also discussion about advantages of cervix sparing operations is still controversial. Aim of the study. Aim was to assess and compare pre- and post-operative quality of sexual life of gynecological patients undergoing planned hysterectomy, and to find out opinions of patients and their partners about expected impact of operation and changes after surgery. Material and methods. Questionnaire method was used to survey gynecologic patients undergoing planned subtotal / total hysterectomy due to benign indication. Sexual Quality of Life Questionnaire – Female (SQoL-F) was used to assess quality of sexual life before and after surgery. Questions about other influencing factors and patients’ opinions before and after operation were added. 38 completed questionnaires were used for data analysis. Results. Only 55% of subtotal hysterectomy group and 38.9% of total hysterectomy group told their partners completely about planned surgery. Mean period of beginning sexual activities after operation was 5.15 weeks after surgery in subtotal hysterectomy and 5.78 weeks in total hysterectomy group. SQoL-F after three months post-operation period was 6.50 points less in total hysterectomy group, which was not statistically significant. There was a slight statistically insignificant decrease of SQoL-F points within each group after three months observation period: -0.44 points in subtotal hysterectomy group and -2.47 points in total hysterectomy group. Although patients of total hysterectomy more frequently (22.2% vs. 5%) indicated negative impact on sexual function after operation, differences were not statistically significant. There were no differences in co-morbidities, concomitant medications, hormone use history and post-operative complications between groups. Conclusions. Patients before hysterectomy are worried about possible negative impact of surgery on their sexual function, they do not talk to their partners candidly about planned surgery. There were no statistically significant changes of sexual quality of life found after subtotal and total abdominal hysterectomy operation after three months observation period.
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    Uterine Prolapse : Immunohistochemical Study of the Pelvic Ligaments
    (2011) Zavorins, Aleksejs; Pilmane, Māra; Lietuviete, Nellija; Institute of Anatomy and Anthropology
    Introduction. Uterine prolapse is a pathological condition when pelvic support system loses elasticity and the uterus descends down into the vagina, leading to pain and even protrusion of tissue from the vagina. Aim of the study. Compare morphology of pelvic ligaments in women with uterine prolapse and without it. Materials and methods. Biopsies of lig. teres uteri were taken during the reconstructive surgery from 7 women with uterine prolapse and the control group of 3 women. Tissues were stained with hematoxilin and eosin, periodic acid – Schiff method and with antibodies of bFGF, FGFR 1, VEGF, PGP 9.5, Collagen III and IV, MMP-9, microscoped at 400X magnification and evaluated semiquantitatively. Data were analysed using non-parametric statistics – Mann – Whitney U test. Results. VEGF was statistically significantly increased (U = 3.5, p = 0.022, two-tailed Mann – Whitney U test) in the prolapse group, in comparison to the control group. Other parameters did not display any statistically significant difference when comparing the two groups, however, amount of GAGs stained with periodic acid – Schiff method showed a notable tendency to decrease in the prolapse group in comparison to the control group. Conclusions. Increased number of VEGF positive endothelium indicates hypoxia and stimulation of angiogenesis in female pelvic ligaments with uterine prolapse. Tendency of GAGs to decrease in the pelvic ligaments of females with uterine prolapse suggests qualitative degradation of tissue.