School of Public Health, Centre for Longitudinal and Life Course Research, The University of Queensland, Public Health Building, Herston Road, Herston, QLD, 4006, Australia.
QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, 4006, Australia.
Qual Life Res. 2018 Jun;27(6):1501-1511. doi: 10.1007/s11136-018-1812-9. Epub 2018 Feb 15.
Hysterectomy is one of the most common gynaecological procedures worldwide. Changes in endocrine function may impact age-associated decline in physical function and these changes may be accelerated by hysterectomy. The aim of this study was to investigate associations between hysterectomy status and self-reported physical function limitations.
Our study sample (n = 8624) came from the mid-cohort (born 1945-1950) of the Australian Longitudinal Study on Women's Health (ALSWH). Self-report of physical function was measured by the Physical Functioning (PF) subscale of the Medical Outcomes Study Short Form Health Survey (SF-36) over seven surveys (1998-2016), categorised into substantial, moderate and minimal PF-limitations. The associations between hysterectomy status and de novo substantial or moderate PF-limitations versus minimal PF-limitations were investigated using log-multinomial regression.
By Survey 8 (2016), 20% of the study sample had a hysterectomy with ovarian conservation (hysterectomy only) and 9% had a hysterectomy and both ovaries removed (hysterectomy-bilateral oophorectomy). Women with a hysterectomy only had a small increase in risk of substantial PF-limitations (versus minimal PF-limitations) compared to women with no hysterectomy (relative risk [RR]: 1.13; 95% confidence interval [95% CI] 1.00-1.27); the point estimate was stronger for women with a hysterectomy-bilateral oophorectomy (RR: 1.26; 95% CI 1.09-1.46). In a supplementary analysis, the increased risk of substantial PF-limitations was seen only in women who had surgery before the age of 45 years.
Compared to women with no hysterectomy, women with hysterectomy-bilateral oophorectomy were at increased risk of substantial PF-limitations versus minimal PF-limitations over 18 years of follow-up.
子宫切除术是全球最常见的妇科手术之一。内分泌功能的变化可能会影响与年龄相关的身体功能下降，而这些变化可能会因子宫切除术而加速。本研究旨在探讨子宫切除术状态与自我报告的身体功能障碍之间的关系。
我们的研究样本（n=8624）来自澳大利亚妇女健康纵向研究（ALSWH）的中期队列（1945-1950 年出生）。身体功能通过医疗结局研究短表单健康调查（SF-36）的身体功能（PF）子量表在七次调查（1998-2016 年）中进行测量，分为明显、中度和轻度 PF 障碍。使用对数多项回归调查子宫切除术状态与新发明显或中度 PF 障碍与轻度 PF 障碍之间的关系。
到第 8 次调查（2016 年），研究样本中有 20%的人接受了子宫切除术保留卵巢（子宫切除术仅），9%的人接受了子宫切除术和双侧卵巢切除术（子宫切除术双侧卵巢切除术）。与未接受子宫切除术的女性相比，仅接受子宫切除术的女性发生明显 PF 障碍的风险略有增加（相对风险 [RR]：1.13；95%置信区间 [95%CI]：1.00-1.27）；对于接受子宫切除术双侧卵巢切除术的女性，这一估计值更强（RR：1.26；95%CI：1.09-1.46）。在一项补充分析中，仅在 45 岁之前接受手术的女性中才发现明显 PF 障碍的风险增加。
与未接受子宫切除术的女性相比，接受子宫切除术双侧卵巢切除术的女性在 18 年的随访中发生明显 PF 障碍的风险更高。
