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绝经前降低风险的输卵管卵巢切除术 15 年后的尿失禁:一项多中心横断面研究。

Urinary incontinence more than 15 years after premenopausal risk-reducing salpingo-oophorectomy: a multicentre cross-sectional study.

机构信息

Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.

Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.

出版信息

BJOG. 2024 Jan;131(1):99-108. doi: 10.1111/1471-0528.17591. Epub 2023 Jul 2.

Abstract

OBJECTIVE

To study the impact of premenopausal risk-reducing salpingo-oophorectomy (RRSO), compared with postmenopausal RRSO, on urinary incontinence (UI) ≥10 years later.

DESIGN

Cross-sectional study, nested in a nationwide cohort.

SETTING

Multicentre in the Netherlands.

POPULATION

750 women (68% BRCA1/2 pathogenic variant carriers) who underwent either premenopausal RRSO (≤45 years, n = 496) or postmenopausal RRSO (≥54 years, n = 254). All participants were ≥55 years at the time of the study.

METHODS

Urinary incontinence was assessed by the urinary distress inventory-6 (UDI-6); a score ≥33.3 indicated symptomatic UI. The incontinence impact questionnaire short form (IIQ-SF) was used to assess the impact on women's health-related quality of life (HR-QoL). Differences between groups were analysed using regression analyses adjusting for current age and other confounders.

MAIN OUTCOME MEASURES

Differences in UDI-6 scores and IIQ-SF scores between women with a premenopausal and a postmenopausal RRSO.

RESULTS

Women in the premenopausal RRSO group had slightly higher UDI-6 scores compared with women in the postmenopausal RRSO group (P = 0.053), and their risk of symptomatic UI was non-significantly increased (odds ratio [OR] 2.1, 95% confidence interval [95% CI] 0.93-4.78). A premenopausal RRSO was associated with a higher risk of stress UI (OR 3.5, 95% CI 1.2-10.0) but not with urge UI. The proportions of women with a significant impact of UI on HR-QoL were similar in the premenopausal and postmenopausal RRSO groups (10.4% and 13.0%, respectively; P = 0.46).

CONCLUSIONS

More than 15 years after premenopausal RRSO, there were no significant differences in overall symptomatic UI between women with a premenopausal and those with a postmenopausal RRSO.

摘要

目的

研究绝经前预防性输卵管卵巢切除术(RRSO)与绝经后 RRSO 相比,对 10 年后发生的尿失禁(UI)的影响。

设计

全国性队列的嵌套横断面研究。

地点

荷兰多中心。

人群

750 名女性(68%为 BRCA1/2 致病性变异携带者),其中 496 名接受了绝经前 RRSO(≤45 岁),254 名接受了绝经后 RRSO(≥54 岁)。所有参与者在研究时均≥55 岁。

方法

通过尿失禁困扰量表-6(UDI-6)评估尿失禁;评分≥33.3 表示有症状性 UI。使用尿失禁影响问卷短表(IIQ-SF)评估对女性健康相关生活质量(HR-QoL)的影响。使用回归分析调整当前年龄和其他混杂因素后,分析组间差异。

主要观察指标

绝经前 RRSO 组与绝经后 RRSO 组之间 UDI-6 评分和 IIQ-SF 评分的差异。

结果

与绝经后 RRSO 组相比,绝经前 RRSO 组的 UDI-6 评分略高(P=0.053),且发生症状性 UI 的风险无显著增加(比值比[OR]2.1,95%置信区间[95%CI]0.93-4.78)。绝经前 RRSO 与压力性 UI 的风险增加相关(OR 3.5,95%CI 1.2-10.0),但与急迫性 UI 无关。绝经前 RRSO 和绝经后 RRSO 组中 UI 对 HR-QoL 有显著影响的女性比例相似(分别为 10.4%和 13.0%;P=0.46)。

结论

绝经前 RRSO 后 15 年以上,绝经前 RRSO 与绝经后 RRSO 相比,女性整体症状性 UI 无显著差异。

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