Hysterectomy and urinary incontinence: a systematic review
Hysterectomy and urinary incontinence: a systematic review
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DOI：
10.1016/s0140-6736(00)02577-0
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发表时间：
2000-08-12
期刊：
影响因子：
168.9
通讯作者：
Grady, D
中科院分区：
文献类型：
--
作者：
Brown, JS;Sawaya, G;Grady, D
背景：在美国，每10000例子宫切除术中，估计约有6名妇女发生子宫切除术后的严重并发症。我们做了一个系统的审查证据表明，子宫切除术与尿incontinent.Methods我们确定了英语和非英语语言的文章注册MEDLINE从1966年1月至1997年12月，做人工参考文献，并咨询专家。我们确定了45篇报道尿失禁和子宫切除术相关性的文章。我们选择的报告，提供了原始数据的发展失禁的妇女进行子宫切除术相比，那些谁没有。结果由两名独立的评论家进行了摘要，并与random-effects model.Findings：12篇论文符合我们的选择标准8个横断面研究，两个前瞻性队列研究，一个病例对照研究，和一个随机对照试验。总的估计值与子宫切除术后尿失禁的几率增加一致。由于子宫切除术后尿失禁可能不会发展多年，我们在评估尿失禁时按年龄对结果进行分层。在60岁或以上的女性中，尿失禁的总体比值比增加了60%（1.6 [95%CI 1.4-1.8]），但60岁以下女性的比值比没有增加。失禁失禁。解释：当女性接受有关子宫切除术后遗症的咨询时，从业者应该讨论晚年失禁可能性增加的可能性。
Background Serious complications after hysterectomy are estimated to occur in around six women per 10 000 hysterectomies in the USA. We did a systematic review of evidence that hysterectomy is associated with urinary incontinence.Methods We identified English-language and non-English-language articles registered on MEDLINE from January, 1966, to December, 1997, did manual review of references, and consulted specialists. We identified 45 articles reporting on the association of urinary incontinence and hysterectomy. We selected reports that presented original data on development of incontinence in women who underwent hysterectomy compared with those who did not. Results were abstracted by two independent reviewers and summarised with a random-effects model.Findings: 12 papers met our selection criteria-eight cross-sectional studies, two prospective cohort studies, one case control study, and one randomised controlled trial. The summary estimate was consistent with increased odds for incontinence in women with hysterectomy. Because incontinence might not develop for many years after hysterectomy, we stratified the findings by age at assessment of incontinence. Among women who were 60 years or older, the summary odds ratio for urinary incontinence was increased by 60% (1.6 [95% CI 1.4-1.8]) but odds were not increased for women younger than 60 years. incontinence incontinence.Interpretation: When women are counselled about sequelae of hysterectomy, practitioners should discuss the possibility of an increased likelihood of incontinence in later life.