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Influence of hysterectomy on long-term fracture risk.

Abstract：

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 indications 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.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Melton LJ 3rd,Achenbach SJ,Gebhart JB,Babalola EO,Atkinson EJ,Bharucha AE

doi

10.1016/j.fertnstert.2006.11.080

subject

Has Abstract

pub_date

2007-07-01 00:00:00

pages

156-62

issue

1

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(06)04558-4

journal_volume

88

pub_type

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