Higher Hysterectomy Risk for Sterilized than Nonsterilized Women: Findings from the U.S. Collaborative Review of Sterilization
Higher Hysterectomy Risk for Sterilized than Nonsterilized Women: Findings from the U.S. Collaborative Review of Sterilization
复制标题
绝育女性比未绝育女性的子宫切除术风险更高：美国绝育协作审查的结果
DOI：
10.1097/00006254-199805000-00013
复制
发表时间：
1998
影响因子：
7.2
通讯作者：
H. Peterson
中科院分区：
文献类型：
--
作者：
S. Hillis;P. Marchbanks;L. Tylor;H. Peterson
目的比较既往绝育妇女和丈夫曾行输精管结扎术妇女子宫切除术的风险，并评估该风险是否因手术年龄或输卵管阻塞方法而存在差异。方法：我们的研究人群包括7718名女性，在1978年至1986年期间参加了一项前瞻性多中心队列研究。在按妇女手术年龄分层后，我们使用生命表方法和调整的风险比来检查在入选后的5年内子宫切除术的相对风险是否在7174名绝育妇女和544名丈夫接受输精管切除术的妇女之间存在差异。结果绝育妇女5年累计子宫切除率为8%，丈夫结扎妇女5年累计子宫切除率为2%。在入组时年龄小于34岁的女性中，绝育女性行子宫切除术的可能性是丈夫行输精管切除术的女性的4.4倍（95%置信区间[CI] 1.9，10.0）。35岁及以上女性的结果相似（率比= 4.6; 95% CI 1.4，14.5）。六种最常用的输卵管阻塞方法中的每一种都与子宫切除术的风险增加有关。结论无论绝育时的年龄如何，接受输卵管绝育术的妇女比丈夫接受输精管结扎术的妇女更有可能在绝育后5年内接受子宫切除术。观察到每种输卵管阻塞方法子宫切除术的风险增加。
Objective To compare the risk of hysterectomy among previously sterilized women and women whose husbands had undergone vasectomy, and to evaluate whether this risk differed by age at surgical procedure or by method of tubal occlusion. Methods Our study population comprised 7718 women enrolled in a prospective, multicenter cohort study between 1978 and 1986. After stratifying by the woman's age at surgical procedure, we used the life-table approach and adjusted hazards ratios to examine whether the relative risk of hysterectomy during the 5 years after enrollment differed between the 7174 women who had been sterilized and the 544 women whose husbands had undergone vasectomy. Results The 5-year cumulative probability of hysterectomy was 8% among the previously sterilized women and 2% among the women whose husbands had undergone vasectomy. Among women 34 years of age and younger at enrollment, sterilized women were 4.4 times as likely to have a hysterectomy as women whose husbands had undergone vasectomy (95% confidence interval [CI] 1.9, 10.0). Findings were similar for women 35 years of age and older (rate ratio = 4.6; 95% CI 1.4, 14.5). Each of the six most commonly used methods of tubal occlusion was associated with an increased risk of hysterectomy. Conclusion Women undergoing tubal sterilization were more likely than women whose husbands underwent vasectomy to undergo hysterectomy within 5 years after sterilization, regardless of age at sterilization. An increased risk of hysterectomy was observed for each method of tubal occlusion.