A COMMUNITY-BASED STUDY OF HYSTERECTOMY OUTCOMES

点击翻译按钮获取中文摘要

Approximately one-third of all women in the U.S. will have a hysterectomy by the age of 60. The present study will evaluate the effect of hysterectomy on long term physical and psychosocial outcomes (including several previously unstudied outcomes), in a population-based sample of 1503 upper-middle class women aged 50-89. Among these women, 45% have had a hysterectomy. The physical outcomes of hysterectomy will include the prevalence of specific menopausal symptoms and of urinary incontinence. The psychosocial outcomes of hysterectomy will include depressed mood, life satisfaction, self-perceptions of physical and emotional functioning and self-rating of health. Comparisons will be made between those with and without a hysterectomy before and after adjusting for potentially confounding covariates. Separate analyses will compare groups of women classified by estrogen use (never, former, current user) and by time since menopause on outcome measures. This study will test the hypotheses that women who have had a hysterectomy and are not using exogenous estrogen will have a higher prevalence of menopausal symptoms and urinary incontinence; higher scores of depressed mood; and lower ratings of life satisfaction, physical and emotional functioning and health that naturally postmenopausal women (whether using or not using exogenous estrogen) and those who had a hysterectomy but report using exogenous estrogen. Analyses will be performed excluding the women with a hysterectomy secondary to cancer (8.6%) as well as including those women but adjusting for history of reproductive cancer. Additionally, among women with a hysterectomy, comparisons will be made between those with and without a bilateral oophorectomy. Funds are requested for the analysis of existing data; computer entry of data collected from a survey of menopausal symptoms; and collection and analysis of new data. Results from this study will increase awareness among physicians of the long term effects of hysterectomy. The information provided by this study could help physicians and counselors prepare women to deal with physical and emotional outcomes they can expect following hysterectomy. Finally, the knowledge gained from this study will assist physicians and patients in weighing the risks and benefits of an elective hysterectomy.