Hysterectomy with or without oophorectomy is a common procedure all over the world, mostly for benign conditions [1,2]. Notwithstanding, the long-term safety of hysterectomy alone has not been accurately evaluated. Studies addressing this issue have methodological flaws: not controlling for pre-existing cardiovascular disease, inclusion of unilateral oophorectomy in the ovarian conservation group, and short-term follow-up [3,4].
Laughlin-Tommaso and colleagues have studied a cohort of 2094 women in Olmsted County in the USA; the women underwent hysterectomy with ovarian conservation (both ovaries) for benign conditions between the years 1980 and 2002, and were matched with women who had not undergone this procedure [5]. Indications for hysterectomy were mainly leiomyomas (39.5%), uterine prolapse (20.3%), and menstrual disorders not specifically defined (25.5%). They evaluated the incidence of de novo cardiovascular disease and associated metabolic conditions, by using electronic registry of the outcome for a median follow up of 21.9 years. The study found a significant correlation between the development of cardiometabolic disease and hysterectomy, in all age groups.
Author(s)
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Stefano Macchiavello
Resident Endocrinology Department, Faculty of Medicine, Pontificia Universidad Católica de Chile -
Paulina Villaseca
Endocrinology Department, Pontificia Universidad Católica de Chile
Citations
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Jacobson GF, Shaber RE, Armstrong MA, Hung YY. Hysterectomy rates for benign indications. Obstet Gynecol 2006;107:1278-83
http://www.ncbi.nlm.nih.gov/pubmed/16738152 -
Wu JM, Wechter ME, Geller EJ, Nguyen TV, Visco AG. Hysterectomy rates in the United States, 2003. Obstet Gynecol 2007;110:1091-5
http://www.ncbi.nlm.nih.gov/pubmed/17978124 -
Falkeborn M, Schairer C, Naessen T, Persson I. Risk of myocardial infarction after oophorectomy and hysterectomy. J Clin Epidemiol 2000;53:832-7
http://www.ncbi.nlm.nih.gov/pubmed/10942866 -
Ingelsson E, Lundholm C, Johansson AL, Altman D. Hysterectomy and risk of cardiovascular disease: a population-based cohort study. Eur Heart J 2011;32:745-50
http://www.ncbi.nlm.nih.gov/pubmed/21186237 -
Laughlin-Tommaso SK, Khan Z, Weaver AL, Smith CY, Rocca WA, Stewart EA. Cardiovascular and metabolic morbidity after hysterectomy with ovarian conservation: a cohort study. Menopause 2018;25:483-92
http://www.ncbi.nlm.nih.gov/pubmed/29286988 -
Perera HK, Ananth CV, Richards CA, et al. Variation in ovarian conservation in women undergoing hysterectomy for benign indications. Obstet Gynecol 2013;121:717-26
http://www.ncbi.nlm.nih.gov/pubmed/23635670 -
Farquhar CM, Sadler L, Harvey SA, Stewart AW. The association of hysterectomy and menopause: a prospective cohort study. BJOG 2005;112:956-62
http://www.ncbi.nlm.nih.gov/pubmed/15957999
