A COMMUNITY-BASED STUDY OF HYSTERECTOMY OUTCOMES

在美国，大约三分之一的女性将有一个 在60岁之前切除子宫 本研究将评估 子宫切除术对远期生理和心理社会结局的影响 （包括几个以前未研究的结果），在一个基于人口的 样本为1503名50-89岁的中上阶层妇女。 在这些女性中， 45%做过子宫切除术。 子宫切除术的身体结果将 包括特定的更年期症状和泌尿系统疾病的流行率， 失禁 子宫切除术的心理社会后果将包括 抑郁情绪，生活满意度，身体和自我感觉 情绪功能和健康自我评价。 将在子宫切除术和没有子宫切除术的患者之间进行比较 在调整潜在混杂协变量之前和之后。 单独的分析将比较按雌激素分类的妇女组 使用（从未使用、既往使用、当前使用）和绝经后时间对结局的影响 措施 这项研究将检验以下假设： 子宫切除术和不使用外源性雌激素将有较高的 绝经期症状和尿失禁的患病率;较高 抑郁情绪评分;生活满意度评分较低， 身体和情感功能和健康， 绝经后妇女（无论是否使用外源性雌激素）和 那些做过子宫切除术但报告使用外源性雌激素的人。 分析将排除子宫切除术的女性 其次是癌症（8.6%），包括那些妇女，但 排除生殖系统癌症史 此外，在妇女中， 与子宫切除术，将进行比较， 不做双侧卵巢切除术 要求提供资金用于分析现有数据; 从绝经期症状调查中收集的数据;以及收集和 分析新数据。 这项研究的结果将提高医生对 子宫切除术的长期影响。 本报告提供的信息 这项研究可以帮助医生和咨询师为女性做好准备， 子宫切除后的生理和心理后果 最后，从这项研究中获得的知识将有助于医生和 患者权衡选择性子宫切除术的风险和益处。

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.