Influence of hysterectomy on long-term fracture risk.
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.
Melton
L Joseph
LJ
Division of Epidemiology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA. melton.j@mayo.edu
Achenbach
Sara J
SJ
Gebhart
John B
JB
Babalola
Ebenezer O
EO
Atkinson
Elizabeth J
EJ
Bharucha
Adil E
AE
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