Postoperative symptoms of hysterectomy have received relatively little attention. In the present study, the first author has personally interviewed and examined 105 abdominal hysterectomy patients and 107 patients with supravaginal uterine amputation preoperatively and 6 weeks, 6 months and 12 months postoperatively. Participation in the follow-up study was 99.5% (211/212) at one year. This paper deals with the effects of the two operations on libido and the frequency of orgasms. In the statistical analysis, McNemar's test of symmetry and the Fisher exact test were used. Weak or absent libido was reported preoperatively by 28.0% of hysterectomy patients and by 26.4% of amputation patients. One year postoperatively the corresponding figures were 35.4% and 31.4%. No statistical changes were observed between the two groups or within either group. In the frequency of orgasms a highly significant (p less than 0.001) reduction from the situation before operation to one year postoperatively was detected after hysterectomy. In the supravaginal amputation group no statistically significant decrease was detected. Preoperatively the two groups were alike; one year postoperatively the difference was almost significant (p less than 0.05). The reductions in orgasms after hysterectomy as compared with supravaginal amputation appears to result from the greater radicality of the former; at hysterectomy, the autonomous innervation of the proximal vagina and cervix is damaged more than in supravaginal amputation, the anatomy of the vagina is altered and scar tissue forms in the vagina. It is probable that these changes and subconscious psychological reactions due to total removal of the uterus explain why supravaginal uterine amputation gives better results than hysterectomy.

Punnonen, R., and Rauramo, L. (Dept. of Obstetrics and Gynaecology, University Hospital, Turku, Finland). Effect of bilateral oophorectomy and peroral estradiol valerate therapy on serum lipids. Int J Gynaecol Obstet 14:13-16, 1976.The effect of bilateral oophorectomy upon serum lipids was studied in 25 women, whose average age was 48 years. One month after castration the triglyceride level was significantly (p<0.01) higher than before the operation. Six months later the triglyceride level had fallen slightly and the difference from the preoperative level was no longer significant. Castration did not have any significant effect on serum cholesterol and phospholipids during the seven-month follow-up period. The effect of peroral estradiol valerate was studied in the same way in 25 women, whose average age was 49 years. Estradiol valerate therapy (2 mg per day) was started one month after castration. After 6 months of treatment the serum phospholipids had increased slightly (p<0.05), but there was no significant effect on the cholesterol and triglyceride levels.

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Electrophysiological parameters were studied in 32 gynecological patients before and after major gynecological surgery. No changes in maximal nerve conduction velocity or simple reaction time could be found after either hysterectomy or ovariectomy. Of the 20 ovariectomized patients, 3 developed subjective symptoms and electrophysiological signs of the carpal tunnel syndrome within a few months after surgery. Thus the carpal tunnel syndrome, which is common in women of menopausal age, seems to be precipitated also by iatrogenic menopause. The present findings indicate that ovarian relaxin overproduction cannot be the basis of the carpal tunnel syndrome, but they are consistent with the view that the syndrome is a sign of hypothalamichypophyseal overactivity or imbalance.