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Histerectomía, ooforectomía y salud ósea: una revisión sistemática y un metanálisis
Md Shariful Islam1, Karen M Tuesley1, Louise F Wilson1
1School of Public Health, The University of Queensland, Brisbane, QLD, Australia.
European journal of endocrinology
|August 22, 2025
Resumen
La ooforectomía bilateral aumenta el riesgo de fractura, mientras que la histerectomía por sí sola puede elevar el riesgo de osteoporosis. Se necesita más investigación para comprender las implicaciones a largo plazo de estas cirugías en la salud ósea.
Área de la Ciencia:
- Ginecología y salud ósea
- Investigación de resultados quirúrgicos
Sus antecedentes:
- La histerectomía y la ovariectomía son procedimientos ginecológicos comunes.
- El impacto de estas cirugías en la salud ósea, incluido el riesgo de fracturas y osteoporosis, requiere una mayor aclaración.
Objetivo del estudio:
- Revisar sistemáticamente y metaanalizar la asociación entre la histerectomía (con o sin ooforectomía) y los resultados de la salud ósea.
- Evaluar el riesgo de fracturas, osteoporosis y cambios en la densidad mineral ósea (DMO) después de estas intervenciones quirúrgicas.
Principales métodos:
- Revisión sistemática y metanálisis de los estudios identificados a través de búsquedas exhaustivas en las bases de datos (PubMed, Embase, Cochrane Central, CINAHL).
- Los criterios de inclusión se centraron en mujeres mayores de 18 años y en estudios que examinaron la histerectomía/ ooforectomía y los parámetros de salud ósea.
- Se incluyeron diecinueve estudios en los metanálisis, sintetizando datos de más de 15.000 artículos seleccionados.
Principales resultados:
- La ooforectomía bilateral aumentó significativamente el riesgo de fractura (RR 1.17) y mostró una tendencia no significativa hacia un mayor riesgo de osteoporosis.
- La histerectomía sin ooforectomía se asoció con un riesgo significativamente mayor de osteoporosis (RR 1,45).
- La histerectomía con ooforectomía bilateral no mostró un mayor riesgo de fractura en comparación con la histerectomía sola; sin embargo, las limitaciones del estudio incluyeron la heterogeneidad y la falta de evaluación detallada de la variable de confusión.
Conclusiones:
- La ooforectomía bilateral está asociada negativamente con la salud ósea, aumentando el riesgo de fractura.
- La histerectomía sola también puede contribuir a un mayor riesgo de osteoporosis.
- Otros estudios longitudinales a gran escala son esenciales para refinar la toma de decisiones clínicas con respecto a la extensión quirúrgica, el tiempo y el uso de medicamentos.
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