Influence of hysterectomy on long-term fracture risk

L. Joseph Melton, Sara J. Achenbach, John B. Gebhart, Ebenezer O. Babalola, Elizabeth J. Atkinson, Adil Eddie Bharucha

Research output: Contribution to journalArticle

10 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)156-162
Number of pages7
JournalFertility and Sterility
Volume88
Issue number1
DOIs
StatePublished - Jul 2007

Fingerprint

Hysterectomy
Confidence Intervals
Uterine Prolapse
Osteoporotic Fractures
Ovariectomy
Wrist
Observational Studies
Hip
Inpatients
Spine
Cohort Studies
Outpatients
Odds Ratio
Outcome Assessment (Health Care)
Population

Keywords

  • cohort study
  • fracture
  • Hysterectomy
  • oophorectomy
  • pelvic prolapse

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Melton, L. J., Achenbach, S. J., Gebhart, J. B., Babalola, E. O., Atkinson, E. J., & Bharucha, A. E. (2007). Influence of hysterectomy on long-term fracture risk. Fertility and Sterility, 88(1), 156-162. https://doi.org/10.1016/j.fertnstert.2006.11.080

Influence of hysterectomy on long-term fracture risk. / Melton, L. Joseph; Achenbach, Sara J.; Gebhart, John B.; Babalola, Ebenezer O.; Atkinson, Elizabeth J.; Bharucha, Adil Eddie.

In: Fertility and Sterility, Vol. 88, No. 1, 07.2007, p. 156-162.

Research output: Contribution to journalArticle

Melton, LJ, Achenbach, SJ, Gebhart, JB, Babalola, EO, Atkinson, EJ & Bharucha, AE 2007, 'Influence of hysterectomy on long-term fracture risk', Fertility and Sterility, vol. 88, no. 1, pp. 156-162. https://doi.org/10.1016/j.fertnstert.2006.11.080
Melton LJ, Achenbach SJ, Gebhart JB, Babalola EO, Atkinson EJ, Bharucha AE. Influence of hysterectomy on long-term fracture risk. Fertility and Sterility. 2007 Jul;88(1):156-162. https://doi.org/10.1016/j.fertnstert.2006.11.080
Melton, L. Joseph ; Achenbach, Sara J. ; Gebhart, John B. ; Babalola, Ebenezer O. ; Atkinson, Elizabeth J. ; Bharucha, Adil Eddie. / Influence of hysterectomy on long-term fracture risk. In: Fertility and Sterility. 2007 ; Vol. 88, No. 1. pp. 156-162.
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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.",
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