Hysterectomies Have Slight Effect on Fracture Risk

Risk of overall fracture is higher after a hysterectomy, but long-term influence on osteoporotic fractures is generally insignificant

THURSDAY, July 26 (HealthDay News) -- Hysterectomies, including oophorectomies, don't increase the long-term risk of osteoporotic fractures of the hip, spine or wrist except in cases in which surgery is performed for uterine prolapse, according to study findings published in the July issue of Fertility and Sterility.

L. Joseph Melton III, M.D., and colleagues from the Mayo Clinic College of Medicine in Rochester, Minn., analyzed a cohort of 9,258 women who had a hysterectomy at a median age of 44 between 1965 and 2002 in Olmsted County, Minn. The investigators compared the number and type of fractures to a matched group of women in the county who didn't have the procedure. The hysterectomy group included pre- and postmenopausal women, those with and without oophorectomy, and included vaginal as well as abdominal hysterectomies.

Researchers found a 1.21-fold increase in the risk of overall fractures among women with hysterectomies compared to controls, but no statistically elevated risk of fractures at skeletal sites traditionally linked to osteoporosis such as the proximal femur, lumbar and thoracic vertebrae or distal forearm. Mechanisms that might influence fracture risk weren't determined in this study.

"Statistically significant increases in overall fracture risk were seen for women operated upon for cancer debulking, endometriosis, uterine prolapse, and menstrual disorders," the authors write. "However, only prolapse was associated with a statistically significant increase in osteoporotic fracture risk."

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