Miller Jay-James R, Botros Sylvia M, Beaumont Jennifer L, Aschkenazi Sarit O, Gamble Tondalaya, Sand Peter K, Goldberg Roger P
Miller Urogynecology, Bloomington, IL, USA.
Am J Obstet Gynecol. 2008 May;198(5):565.e1-4. doi: 10.1016/j.ajog.2008.01.046.
This study uses the unique properties of twin research design to evaluate whether hysterectomy impacts stress urinary incontinence (SUI).
As part of the Evanston Twins Sister Study, we performed bivariate and multivariate analyses on 83 identical twin pairs discordant for hysterectomy.
In bivariate analysis, SUI was less common in women who had prior hysterectomy (P =0.028). Multivariate analysis suggested that SUI was significantly less common after hysterectomy (odds ratio [OR], 0.55, confidence interval [CI], 0.30 to 1.00). Exclusion of twin pairs with a history of pelvic floor defect surgery eliminated the statistical relationship between hysterectomy and SUI (OR, 0.79, CI, 0.4 to 1.40).
Hysterectomy, when analyzed with all cases, was associated with reduced SUI. When concurrent pelvic floor defect surgeries were excluded from the analysis, we found no relationship between hysterectomy and the risk of SUI afterward.
本研究利用双生子研究设计的独特特性，评估子宫切除术是否会影响压力性尿失禁（SUI）。
作为埃文斯顿双胞胎姐妹研究的一部分，我们对83对子宫切除术情况不一致的同卵双胞胎进行了双变量和多变量分析。
在双变量分析中，既往接受过子宫切除术的女性中压力性尿失禁较少见（P = 0.028）。多变量分析表明，子宫切除术后压力性尿失禁明显较少见（优势比[OR]为0.55，置信区间[CI]为0.30至1.00）。排除有盆底缺陷手术史的双胞胎后，子宫切除术与压力性尿失禁之间的统计关系消失（OR为0.79，CI为0.4至1.40）。
在分析所有病例时，子宫切除术与压力性尿失禁减少有关。当分析中排除同期盆底缺陷手术时，我们发现子宫切除术与术后压力性尿失禁风险之间没有关系。
