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Moosazadeh M, Asadi-Aliabadi M, Ghasemi Tirtashi M, Pejman M, Gheibi M, Ghadirzadeh E. Prevalence of hysterectomy and its determinants in northern Iran: enrollment results of the Tabari cohort study. BMC Womens Health 2024; 24:502. [PMID: 39261840 DOI: 10.1186/s12905-024-03338-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Accepted: 08/27/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND To the best of our knowledge, no population-based studies have provided insights into the prevalence of hysterectomy and its risk factors among northern Iranian females. Thus, the present study aimed to investigate the prevalence and sociodemographic determinants of hysterectomy in a large cohort of northern Iranian females. METHODS This cross-sectional study included data from the enrollment phase of the Tabari cohort study (TCS). The TCS consists of 10,255 adults (4,149 males and 6,106 females) aged 35-70 years who reside in Sari, Mazandaran, Iran, of which 6103 females were included in the study. Multiple logistic regression analysis was used to search for hysterectomy determinants. RESULTS Our results revealed that the prevalence of hysterectomy among northern Iranian females was 9.7% (595/6103). Additionally, 50-59 (OR: 4.63, 95% CI: 3.57-6.01) and 60-70 (OR: 5.83, 95% CI: 4.28-7.95) age groups, higher socioeconomic levels (OR: 1.66, 95% CI: 1.13-2.42), a history of tubectomy (OR: 1.27, 95% CI: 1.05-1.53), and more gravida (OR: 5.35, 95% CI: 1.62-17.63) were found to increase the odds of hysterectomy, whereas living in mountainous areas (OR: 0.57, 95% CI: 0.43-2.75) and having a job (OR: 0.62, 95% CI: 0.45-0.86) were found to decrease the odds of hysterectomy. CONCLUSION Older age groups, living in urban areas, higher socioeconomic levels, not having a job, a history of tubectomy, and more gravida were found to increase the odds of hysterectomy.
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Affiliation(s)
- Mahmood Moosazadeh
- Gastrointestitional Cancer Research Center, Non- Communicable Disease Institute, Mazandaran University of Medical Sciences, Sari, P.O.BOX: 4816117949, Iran
| | - Mehran Asadi-Aliabadi
- Epidemiology Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Maliheh Ghasemi Tirtashi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Mobina Gheibi
- Department of Medical Laboratory Sciences, Razi Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Erfan Ghadirzadeh
- Gastrointestitional Cancer Research Center, Non- Communicable Disease Institute, Mazandaran University of Medical Sciences, Sari, P.O.BOX: 4816117949, Iran.
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Brennand EA, Scime NV, Huang B, McDonagh Hull P. Education level is associated with the occurrence and timing of hysterectomy: A cohort study of Canadian women. Acta Obstet Gynecol Scand 2024. [PMID: 39223035 DOI: 10.1111/aogs.14959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 07/22/2024] [Accepted: 08/13/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION Hysterectomy is a common surgery with discernible practice variations that could be influenced by socioeconomic factors. We examined the association between level of educational attainment and the occurrence and timing of hysterectomy in Canadian women. MATERIAL AND METHODS We conducted a prospective cohort study of 30 496 females in the Alberta's Tomorrow Project (2000-2015) followed approximately every 4 years using self-report questionnaires. Educational attainment was defined as high school diploma or less, college degree, university degree (reference group), and postgraduate degree. We used logistic regression analyzing hysterectomy occurrence at any time and before menopause, separately, and flexible parametric survival models analyzing hysterectomy timing with age as the time scale. Multivariable models controlled for race/ethnicity, rural/urban residence, parity, oral contraceptive use, and smoking. RESULTS Overall, 39.1% of females reported a high school diploma or less, 28.9% reported a college degree, 23.5% reported a university degree, and 8.5% reported a postgraduate degree. A graded association was observed between lower education and higher odds of hysterectomy (high school or less: adjusted odds ratio [AOR] 1.68, 95% CI 1.55-1.82; college degree: AOR 1.58, 95% CI 1.45-1.72); results were similar for premenopausal hysterectomy. A graded association between lower education and earlier timing of hysterectomy was also observed up to approximately age 60 (e.g., at age 40: high school or less adjusted hazard ratio [AHR] 1.61, 95% CI 1.49-1.75; college degree AHR 1.53, 95% CI 1.40-1.67). CONCLUSIONS Women with lower levels of education were more likely to experience hysterectomy, including hysterectomy before menopause and at younger ages.
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Affiliation(s)
- Erin A Brennand
- Department of Obstetrics & Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Natalie V Scime
- Department of Obstetrics & Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Health and Society, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Beili Huang
- Department of Obstetrics & Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Pauline McDonagh Hull
- Department of Obstetrics & Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Pecorella G, Morciano A, Sparic R, Tinelli A. Literature review, surgical decision making algorithm, and AGREE II-S comparison of national and international recommendations and guidelines in pelvic organ prolapse surgery. Int J Gynaecol Obstet 2024. [PMID: 38760975 DOI: 10.1002/ijgo.15614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/26/2024] [Accepted: 04/30/2024] [Indexed: 05/20/2024]
Abstract
The average lifespan has increased over time due to improvements in quality of life, leading to an aging population that stays healthy for longer. Pelvic organ prolapse (POP), whether uterine or vaginal, is a problem that severely impairs quality of life and imposes significant restrictions. The present study provides the reader with a summary of the many surgical techniques used in POP surgery, comparing international guidelines, offering an algorithm that is simple to understand, and allows the reader to quickly choose the table that includes the best surgical therapy for each individual. Using relevant keywords, the writers searched the PubMed and Scopus databases for relevant publications from 2000 to April 2023. Studies with cases of oncologic disorders or prior hysterectomy performed for another reason were not included in the analysis. Ten distinct international guidelines are highlighted and examined in the present study. We used the Appraisal of Guidelines for Research and Evaluation II-S (AGREE II-S) method to assess their quality, and incorporated the results into the conclusion. Worldwide, anterior colporrhaphy is the preferred method of treating anterior compartment abnormalities, and mesh is virtually always used when recurrence occurs (which happens in about half of the cases). Worldwide, posterior colporrhaphy is commonly used to repair posterior compartment abnormalities. Only a few national guidelines (the Iranian guideline, Acta Obstetricia et Gynecologica Scandinavica [AOGS], and the German-speaking countries) permit the use of mesh or xenograft in cases of recurrence. There is agreement on the abdominal approach (sacrocolpopexy) with mesh for treating apical deformities. Sacrospinous-hysteropexy is the standard method used to guide the vaginal approach; mesh is typically used to aid in this process. There are just three recommendations that do not include vaginal operations: HSE, AOGS, and Iran. Of obliteration techniques, colpocleisis is unquestionably the best. In conclusion, our analysis highlights the significance of customized methods in POP surgery, taking into account the requirements and preferences of each patient. To choose the best surgical therapy, criteria and patient features must be carefully considered.
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Affiliation(s)
- Giovanni Pecorella
- Department of Gynecology, Obstetrics and Reproduction Medicine, Saarland University, Homburg, Germany
| | - Andrea Morciano
- Department of Gynecology and Obstetrics, Panico Pelvic Floor Center, Pia Fondazione "Card. G. Panico", Tricase, Italy
| | - Radmila Sparic
- Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Andrea Tinelli
- Department of Obstetrics and Gynecology, and CERICSAL (CEntro di RIcerca Clinico SALentino), "Veris delli Ponti Hospital", Scorrano, Italy
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Yuk JS, Cho IC, Lee JH. The Risk of Stress Urinary Incontinence After Hysterectomy for Uterine Fibroids. Int Neurourol J 2023; 27:252-259. [PMID: 38171325 PMCID: PMC10762370 DOI: 10.5213/inj.2346192.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/10/2023] [Indexed: 01/05/2024] Open
Abstract
PURPOSE We evaluated the relationship between previous hysterectomy for uterine fibroids and subsequent stress urinary incontinence (SUI). METHODS This study analyzed national health insurance data. The hysterectomy group (aged 40 to 59) comprised patients who underwent hysterectomy for uterine fibroids between January 1, 2011 and December 31, 2014, and the control group (aged 40 to 59) comprised patients who visited a medical facility for a checkup during the same time span. One-to-one propensity score matching was performed to balance confounders. SUI was defined as the need for SUI surgery accompanied by a diagnosis code for SUI. RESULTS After matching, 81,373 cases (hysterectomy group) and 81,373 controls (nonhysterectomy group) were enrolled. The mean follow-up period was 7.9 years for the cases and 7.8 years for the controls. The incidence of anti-incontinence surgery was slightly but significantly higher in the cases than in the controls (2.0% vs. 1.7%, P<0.001). Compared to the control group, abdominal hysterectomy significantly increased the likelihood of anti-incontinence surgery both before (hazard ratio [HR], 1.235; 95% confidence interval [CI], 1.116-1.365) and after adjusting for confounders (HR, 1.215; 95% CI, 1.097-1.347). In contrast, laparoscopic hysterectomy, laparoscopic hysterectomy with adnexal surgery, and abdominal hysterectomy with adnexal surgery were not associated with an increased rate of anti-incontinence surgery. The significant association between abdominal hysterectomy and an elevated rate of anti-incontinence surgery persisted even after stratifying patients by age group. CONCLUSION Prior abdominal hysterectomy without adnexal surgery was associated with an increased incidence of subsequent anti-urinary incontinence surgery.
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Affiliation(s)
- Jin-Sung Yuk
- Department of Obstetrics and Gynecology, Inje University Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, Korea
| | - In-Chang Cho
- Department of Urology, National Police Hospital, Seoul, Korea
| | - Jun Ho Lee
- Department of Urology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
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Venable SR, Al-Hendy A. Uterine Fibroids: A Podcast on Patient and Physician Perspectives on Medical Management and a New Medical Therapy (Relugolix Combination Therapy). Adv Ther 2023; 40:4127-4133. [PMID: 37568061 PMCID: PMC10499739 DOI: 10.1007/s12325-023-02595-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/26/2023] [Indexed: 08/13/2023]
Abstract
Uterine fibroids (UF) are common benign tumors in women and are an important health concern in the US and globally. UF can severely compromise a woman's quality of life, thus making it an important health issue. In this podcast, a professor of Obstetrics and Gynecology, University of Chicago (Dr. Ayman Al-Hendy) and the CEO of the Fibroid Foundation (Sateria Venable) provide their perspectives on the diagnosis and management of UF, including common treatments (e.g., myomectomy or hysterectomy). They also discuss Relugolix combination therapy for UF, noting who could benefit from this treatment and how it works. Podcast audio available for this article.
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Affiliation(s)
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave., Chicago, IL, 60637, USA.
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Yuk JS, Lee JH. Risk of overactive bladder after hysterectomy for uterine fibroids. Int Urogynecol J 2023; 34:1823-1829. [PMID: 36752850 DOI: 10.1007/s00192-023-05474-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/13/2023] [Indexed: 02/09/2023]
Abstract
INTRODUCTION AND HYPOTHESIS We evaluated the association between previous hysterectomy for uterine fibroids and the risk of developing overactive bladder (OAB). METHODS We used national health insurance data. The hysterectomy group (aged 40 to 59) comprised patients who underwent hysterectomy for uterine leiomyoma or adenomyosis between 1 January 2011 and 31 December 2014, and the control group (aged 40 to 59) comprised patients who visited a medical facility for a checkup during the same time period. Propensity score matching (PSM, 1:1) was performed to balance confounders. OAB events were defined by drug prescriptions (beta 3 agonist or anticholinergics) for more than 1 month based on previous studies. RESULTS After matching, 58,195 cases (hysterectomy group) and 58,195 controls (nonhysterectomy group) were enrolled. The mean follow-up period was 7.9 years in the nonhysterectomy group and 8.0 years in the hysterectomy group. There was no significant difference in the rate of OAB development between the groups (0.3% vs 0.3%; p=0.061). Additionally, compared with the nonhysterectomy group (hazard ratio: 1 (reference)), hysterectomy without adnexal surgery (hazard ratio: 1.169 [0.915-1.493]) and hysterectomy with adnexal surgery (hazard ratio: 1.342 [0.83-2.171]) did not significantly increase the risk of OAB after adjusting for confounders; this relationship remained nonsignificant after stratifying patients according to age group. CONCLUSIONS Previous hysterectomy with or without adnexal surgery for the treatment of uterine fibroids did not increase the risk of developing OAB, defined as drug therapy lasting more than 1 month.
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Affiliation(s)
- Jin-Sung Yuk
- Department of Obstetrics and Gynecology, Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, Republic of Korea
| | - Jun Ho Lee
- Department of Urology, Nowon Eulji Medical Center, Eulji University School of Medicine, 327, Gongneung-ro, Nowon-gu, Seoul, 01830, South Korea.
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Yu YH, Zhang HJ, Yang F, Xu L, Liu H. Curcumol, a major terpenoid from Curcumae Rhizoma, attenuates human uterine leiomyoma cell development via the p38MAPK/NF-κB pathway. JOURNAL OF ETHNOPHARMACOLOGY 2023; 310:116311. [PMID: 36894110 DOI: 10.1016/j.jep.2023.116311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/19/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Uterine fibroids (UFs) are the most common benign tumors in women of reproductive age. Curcumae Rhizoma, the main essential oil component of which is curcumol, is widely used for the treatment of phymatosis in China due to its antitumor, anti-inflammatory, antithrombin, anti-tissue fibrosis and anti-oxygen pharmacological activities, but its potential for the treatment of UFs has not been evaluated. AIM OF THE STUDY This study aimed to investigate the effects and mechanisms of curcumol intervention in human uterine leiomyoma cells (UMCs). MATERIALS AND METHODS Putative targets of curcumol intervention in UFs were identified using network pharmacology strategies. Molecular docking was performed to assess the binding affinity of curcumol to core targets. A concentration gradient of curcumol (0, 50, 100, 200, 300, 400 and 500 μM) or RU-486 (mifepristone, 0, 10, 20, 40, 50, and 100 μM) was applied to UMCs, and cell viability was detected by the CCK-8 assay. Cell apoptosis and cell cycle were examined by flow cytometry, and cell migration was assessed by a wound-healing assay. Additionally, the mRNA and protein expression levels of critical pathway components were evaluated by RT‒PCR and western blotting. Finally, the actions of curcumol on different tumor cell lines were summarized. RESULTS Network pharmacology predicted 62 genes with roles in the treatment of UFs with curcumol, and MAPK14 (p38MAPK) displayed a higher interaction degree. GO enrichment and KEGG analyses revealed that the core genes were abundantly enriched in the MAPK signaling pathway. The molecular binding of curcumol to core targets was relatively stable. In UMCs, 200, 300 and 400 μM curcumol treatment for 24 h decreased cell viability compared with that in the control group, and the greatest effect was detected at 48 h and maintained until 72 h. Curcumol arrested cells in the G0/G1 phase and subsequently suppressed mitosis, promoted early apoptosis and reduced the degree of wound healing in a concentration-dependent manner in UMCs. Furthermore, 200 μM curcumol decreased the mRNA and protein expression of p38MAPK, the mRNA expression of NF-κB, and the protein expression of Ki-67 and increased the mRNA and protein expression of Caspase 9. Curcumol (300 and 400 μM) decreased the mRNA and protein expression of p38MAPK, NF-κB, and Ki-67 and increased the protein expression of Caspase 9 in UMCs. Curcumol was demonstrated to treat tumor cell lines, including breast cancer, ovarian cancer, lung cancer, gastric cancer, liver cancer and nasopharyngeal carcinoma, but its effects on benign tumors have not yet been reported. CONCLUSION Curcumol suppresses cell proliferation and cell migration while arresting the cell cycle in the G0/G1 phase and inducing cell apoptosis in UMCs via a mechanism related to p38MAPK/NF-κB pathway regulation. Curcumol may be a potential therapeutic and preventive agent in the treatment of benign tumors such as UFs.
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Affiliation(s)
- Yong-Hui Yu
- Gynecological Department of Traditional Chinese Medicine, China-Japan Friendship Hospital, Chaoyang District, Beijing, 100029, China
| | - Hao-Jun Zhang
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Chaoyang District, Beijing, 100029, China
| | - Fang Yang
- Gynecological Department of Traditional Chinese Medicine, China-Japan Friendship Hospital, Chaoyang District, Beijing, 100029, China
| | - Lin Xu
- Gynecological Department of Traditional Chinese Medicine, China-Japan Friendship Hospital, Chaoyang District, Beijing, 100029, China
| | - Hong Liu
- Gynecological Department of Traditional Chinese Medicine, China-Japan Friendship Hospital, Chaoyang District, Beijing, 100029, China.
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Desai S, Singh RJ, Govil D, Nambiar D, Shukla A, Sinha HH, Ved R, Bhatla N, Mishra GD. Hysterectomy and women's health in India: evidence from a nationally representative, cross-sectional survey of older women. Womens Midlife Health 2023; 9:1. [PMID: 36609516 PMCID: PMC9825041 DOI: 10.1186/s40695-022-00084-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/28/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Hysterectomy, particularly when conducted in women younger than 45 years, has been associated with increased risk of non-communicable diseases. In India, research indicates that hysterectomy is a common procedure for women, but there have been no studies on its long-term effects. We examined patterns of hysterectomy amongst women in India and associations with their health and well-being in later life. METHODS This analysis utilised the first wave of the Longitudinal Study on Aging in India, a nationally representative study of adults that included a module on health and well-being. We analysed data on 35,083 women ≥45 years in India. We estimated prevalence of hysterectomy and performed multivariable logistic regression to identify associated risk factors and to examine the association between hysterectomy status and eight self-reported chronic conditions, hospitalisation and mobility. RESULTS The prevalence of hysterectomy among women >=45 years was 11.4 (95% CI: 10.3, 12.6), with higher odds among urban women (aOR: 1.39; 1.17,1.64) and higher economic status (highest compared to lowest quintile: aOR: 1.95; 1.44, 2.63). Hysterectomy history was associated with four chronic conditions: hypertension (aOR: 1.51; 95% CI: 1.28, 1.79), high cholesterol (aOR: 1.43; 1.04, 1.97), diabetes (aOR: 1.69; 1.28, 2.24), and bone/joint disease (aOR: 1.54; 1.20, 1.97) and higher odds of any hospitalisation in the past year (aOR: 1.69; 1.36, 2.09). CONCLUSIONS In India, evidence suggests that hysterectomy is associated with major chronic conditions. The assessment for hysterectomy as a treatment option for gynaecological morbidity should consider potential health consequences in later life.
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Affiliation(s)
- Sapna Desai
- grid.510878.3Population Council Institute, Zone 5A India Habitat Centre, Lodhi Road, New Delhi, 110003 India
| | - Roopal Jyoti Singh
- grid.510878.3Population Council Institute, Zone 5A India Habitat Centre, Lodhi Road, New Delhi, 110003 India
| | - Dipti Govil
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Mumbai, India
| | - Devaki Nambiar
- grid.464831.c0000 0004 8496 8261George Institute for Global Health, New Delhi, India
| | | | - Hemali Heidi Sinha
- grid.413618.90000 0004 1767 6103Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Patna, India
| | - Rajani Ved
- Bill & Melinda Gates Foundation, New Delhi, India
| | - Neerja Bhatla
- grid.413618.90000 0004 1767 6103Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Gita D. Mishra
- grid.1003.20000 0000 9320 7537University of Queensland School of Public Health, Herston, Queensland Australia
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Rajkumari S, Chaudhary V, Kasaudhan S, Saraswathy KN. Incidence and determinants of hysterectomy among North Indian women: An 8-year follow-up study. Front Public Health 2022; 10:1065081. [PMID: 36589953 PMCID: PMC9800844 DOI: 10.3389/fpubh.2022.1065081] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
Background Despite indications of a rapid increase in the number of hysterectomies performed in India, very few studies have methodically investigated the rate and determinants of the incidence of hysterectomy. The present study aims to estimate the rate of incidence of hysterectomy and identify predictors/determinants of incident hysterectomy in a cohort of North Indian women. Methods In the present study, a cohort of 1,009 ever-married North Indian women (aged 30-75 years) was followed up after a median of 8.11 years. Those hysterectomized at the baseline (63) were excluded; and of the rest 946 participants, 702 (74.2%) could be successfully followed-up. During the baseline assessment, data about sociodemographic variables, reproductive history, menopausal status, physiological health, and selected blood biochemicals were collected. During the end-line assessment, data about sociodemographic variables, current menopausal status, and incident hysterectomy were recorded. Results The overall rate of incidence of hysterectomy was found to be 11.59 per 1,000 women-years, in the study population. Interestingly, the incidence rates were found to be similar among pre- and post-menopausal women. Further, while late age at menarche was found to be negatively associated with incident hysterectomy, folate repletion and high triglyceride (TG) at the baseline were found to be positively associated. Conclusions High rate of incident hysterectomy in the studied population points toward the huge burden of gynecological morbidity and the unavailability of non-invasive protocols. Such a situation warrants immediate policy intervention. Further, maintaining TG and folate within normal physiological ranges may be beneficial in gynecological ailments necessitating hysterectomy.
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Muacevic A, Adler JR. Cardiometabolic Risk and Cardiovascular Disease in Young Women With Uterine Fibroids. Cureus 2022; 14:e30740. [PMID: 36447683 PMCID: PMC9699995 DOI: 10.7759/cureus.30740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2022] [Indexed: 01/25/2023] Open
Abstract
Uterine fibroids are associated with hypertension and cardiometabolic risk factors, yet the onset and severity of cardiovascular disease (CVD) in women with fibroids remain understudied. We used data from the National Health and Nutrition Examination Survey to assess the association between uterine fibroids, cardiometabolic risk, and CVD (ischemic heart disease, heart failure, and stroke). Among 5,552 women aged 20-54 years in our sample. Hypertension was more common in those diagnosed with fibroids (n=700; 33.4% vs. 15.3% in controls, p<0.001), but these women were also older (44 (SD=7) years vs. 35 (SD=10) years). When stratified by median age, women aged 35 or younger with fibroids (n=97) were more likely than controls (n=2771) to have hypertension (14.1% vs. 2.4%), obesity (51.5% vs. 32.5%), and diabetes mellitus (4.8% vs. 1.9%). Women older than 35 with fibroids also had higher cardiometabolic risk and rates of CVD than controls (8.5% vs. 4.5%). The odds ratio of CVD in women with fibroids, compared to the controls, was 3.10 with 95% confidence interval (CI) of 2.21 to 4.34. The odds ratio decreased to 1.63 (95%CI: 1.11 to 2.38) after adjusting for age, BMI, African ancestry, fasting plasma glucose, cholesterol, education, smoking history, and postmenopausal status and to 1.60 (95%CI: 1.08 to 2.37) after further adjusting for systolic blood pressure. These data indicate that uterine fibroids are associated with a worse cardiovascular risk profile, including hypertension, in relatively young women, leading to early CVD. A women-specific research agenda is urgently needed to study the nature of these associations and design preventive strategies to prevent cardiovascular events in young women with fibroids.
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