McPherson K, Herbert A, Judge A, Clarke A, Bridgman S, Maresh M, Overton C
Nuffield Department of Obstetrics and Gynaecology, Oxford, UK.
J Obstet Gynaecol. 2005 Jul;25(5):469-75. doi: 10.1080/01443610500235170.
We have examined the contribution of hysterectomy, compared with less invasive surgery, for dysfunctional uterine bleeding (DUB) on the prevalence of bladder problems five years after surgery. We report a prospective cohort study of over 25,000 women treated for benign cause menorrhagia by three types of surgery - transcervical endometrial resection/ablation and hysterectomy with or without bilateral oophorectomy. Postal questionnaires were sent five years after surgery investigating satisfaction with surgery and bladder function. When adjusted for confounders the odds of severe urinary incontinence (OR = 1.59, CI 95%, 1.35 - 1.87), urinary frequency (1.23 (1.04 - 1.45)), and nocturia (1.19, (1.03 - 1.38)) - were increased for women who had a hysterectomy compared with endometrial ablation. Hysterectomy with bilateral oophorectomy was not as strongly associated with severe bladder problems. Women who had the LAVH were most likely to report severe urinary incontinence (2.02, CI 95% 1.32 - 3.07), but not severe frequency or nocturia.
我们比较了子宫切除术与侵入性较小的手术对功能失调性子宫出血（DUB）患者术后五年膀胱问题患病率的影响。我们报告了一项对超过25000名因良性月经过多接受三种手术治疗的女性进行的前瞻性队列研究，这三种手术分别是经宫颈子宫内膜切除术/消融术以及有或没有双侧卵巢切除术的子宫切除术。术后五年通过邮寄问卷来调查患者对手术的满意度和膀胱功能。在对混杂因素进行调整后，与子宫内膜消融术相比，接受子宫切除术的女性出现严重尿失禁（比值比=1.59，95%置信区间为1.35 - 1.87）、尿频（1.23（1.04 - 1.45））和夜尿症（1.19，（1.03 - 1.38））的几率增加。双侧卵巢切除的子宫切除术与严重膀胱问题的关联并不那么强烈。接受腹腔镜辅助阴式子宫切除术（LAVH）的女性最有可能报告严重尿失禁（2.02，95%置信区间为1.32 - 3.07），但不是严重尿频或夜尿症。
