title: Influence of hysterectomy on long-term fracture risk.
abstract: OBJECTIVE
  To assess long-term fracture risk after hysterectomy, with or without oophorectomy.
  
  
  METHODS
  Population-based, cohort study.
  
  
  METHODS
  Olmsted County, Minnesota.
  
  
  METHODS
  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.
  
  
  METHODS
  Observational study of the effect of hysterectomy for various indications on subsequent fractures.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Epidemiology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA. melton.j@mayo.edu
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Melton
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Achenbach
authors.forename: John B
authors.initials: JB
authors.lastname: Gebhart
authors.forename: Ebenezer O
authors.initials: EO
authors.lastname: Babalola
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Atkinson
authors.forename: Adil E
authors.initials: AE
authors.lastname: Bharucha
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000639:trends*; D008875:Middle Aged; D012307:Risk Factors; D013995:Time