Kudish Bela I, Shveiky David, Gutman Robert E, Jacoby Vanessa, Sokol Andrew I, Rodabough Rebecca, Howard Barabara V, Blanchette Patricia, Iglesia Cheryl B
Division of Urogynecology, Obstetrics and Gynecology, Winnie Palmer Hospital, Orlando, FL, USA,
Int Urogynecol J. 2014 Nov;25(11):1523-31. doi: 10.1007/s00192-014-2422-x. Epub 2014 Jun 26.
To evaluate an association between hysterectomy and urinary incontinence (UI) in postmenopausal women.
Women (aged 50-79) with uteri (N = 53,569) and without uteri (N = 38,524) who enrolled in the Women's Health Initiative (WHI) Observational Study between 1993 and 1996 were included in this secondary analysis. Baseline (BL) and 3-year demographic, health/physical forms and personal habit questionnaires were used. Statistical analyses included univariate and logistic regression methods.
The baseline UI rate was 66.5 %, with 27.3 % of participants having stress urinary incontinence (SUI), 23 % having urge UI (UUI), and 12.4 % having mixed UI (MUI). 41.8 % of women had undergone hysterectomy, with 88.1 % having had the procedure before age 54. Controlling for health/physical variables, hysterectomy was associated with UI at BL (OR 1.25, 95 % CI 1.19, 1.32) and over the 3-year study period (OR 1.23, 95 % CI 1.11, 1.36). Excluding women with UI at BL, a higher incidence of UUI and SUI episodes was found in hysterectomy at year 3. Among women who had undergone hysterectomy, those with bilateral oophorectomy (BSO) did not have increased odds of developing UI at BL or over the 3-year study period. Hormone use was not associated with a change in UI incidence (estrogen + progesterone, p = 0.17; unopposed estrogen, p = 0.41).
Risk of UI is increased in postmenopausal women who had undergone hysterectomy compared with women with uteri.
评估绝经后女性子宫切除术与尿失禁（UI）之间的关联。
纳入1993年至1996年间参加女性健康倡议（WHI）观察性研究的有子宫女性（年龄50 - 79岁，N = 53569）和无子宫女性（N = 38524）进行此次二次分析。使用基线（BL）以及3年的人口统计学、健康/身体状况表格和个人习惯调查问卷。统计分析包括单变量和逻辑回归方法。
基线尿失禁率为66.5%，其中27.3%的参与者有压力性尿失禁（SUI），23%有急迫性尿失禁（UUI），12.4%有混合性尿失禁（MUI）。41.8%的女性接受过子宫切除术，其中88.1%在54岁之前接受该手术。在控制健康/身体变量后，子宫切除术与基线时的尿失禁相关（比值比1.25，95%置信区间1.19，1.32）以及在3年研究期间（比值比1.23，95%置信区间1.11，1.36）。排除基线时有尿失禁的女性，在第3年子宫切除术中发现UUI和SUI发作发生率更高。在接受过子宫切除术的女性中，那些进行双侧卵巢切除术（BSO）的女性在基线时或3年研究期间发生尿失禁的几率没有增加。激素使用与尿失禁发生率的变化无关（雌激素 + 孕激素，p = 0.17；单纯雌激素，p = 0.41）。
与有子宫的女性相比，接受过子宫切除术的绝经后女性尿失禁风险增加。
