期刊
FERTILITY AND STERILITY
卷 88, 期 1, 页码 156-162出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.fertnstert.2006.11.080
关键词
hysterectomy; fracture; cohort study; oophorectomy; pelvic prolapse
资金
- NIAMS NIH HHS [AR30582, R01 AR030582-42, R01 AR030582] Funding Source: Medline
- NIA NIH HHS [P01 AG004875-24, P01 AG004875, AG04875] Funding Source: Medline
- NICHD NIH HHS [HD41129, R01 HD041129, R01 HD041129-05] Funding Source: Medline
Objective: To assess long-term fracture risk after hysterectomy, with or without oophorectomy. Design: Population-based, cohort study. Setting: Olmsted County, Minnesota. Patient(s): Women residing in Olmsted County (n = 9,258) who underwent hysterectomy in 1965-2002, compared to an equal number of age- and sex-matched community controls. Intervention(s): Observational study of the effect of hysterectomy for various indications on subsequent fractures. Main Outcome Measure(s): Fractures of any type, and at osteoporotic sites (e.g., hip, spine, or wrist) alone, as assessed by electronic review of inpatient and, outpatient diagnoses in the community. Result(s): Compared with controls, there was a significant increase (hazard ratio [HR], 1.21; 95% confidence interval [CI], 1.13-1.29) in overall fracture risk among the women with a hysterectomy, but osteoporotic fracture risk was not elevated (HR, 1.09; 95% CI, 0.98-1.22). Most hysterectomy indication were associated with fractures generally, although these were not often statistically significant. Only operations for a uterine prolapse were associated with osteoporotic fractures (HR. 1.33; 95% CI, 1.01-1.74). Oophorectomy was not an independent predictor of fracture risk (HR, 1.0; 95% CI, 0.98-1.15). Conclusion(s): Hysterectomy does not appear to pose much long-term risk for fractures, but the association of fractures with surgery for uterine prolapse deserves further attention.
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