切除子宫和尿失禁:一个系统的审查
J S Brown1, G Sawaya, D H Thom
1Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, USA. brownj@obgyn.ucsf.edu
Lancet (London, England)
|August 19, 2000
概括
切除子宫可能会增加尿失禁的风险,特别是在60岁及以上的女性中. 在咨询期间讨论这种潜在的长期并发症对于明智的患者决策至关重要.
科学领域:
- 妇科 妇科 妇科 妇科
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 基于证据的医学是基于证据的医学.
背景情况:
- 切除子宫是一个常见的妇科手术.
- 严重的并发症发生在每1万例子宫切除术中约有6例.
- 与尿失禁的潜在关联需要进行调查.
研究的目的:
- 系统地审查将子宫切除与尿失禁联系在一起的证据.
- 为了量化胚胎切除术后发生尿失禁的风险.
主要方法:
- 从MEDLINE (1966-1997) 和参考列表中对英语和非英语文章进行系统审查.
- 包括报告有关宫内切除术后失禁发展原始数据的研究.
- 数据抽象由两个独立的审稿人,并使用随机效应模型进行元分析.
主要成果:
- 12项研究 (8项截面研究,2项队列研究,1项病例对照研究,1项RCT) 符合纳入标准.
- 整体而言,子宫切除与尿失禁的几率增加有关.
- 60岁以上的女性表现出尿失禁的几率增加了60% (OR1.6),而年轻女性的几率没有增加.
结论:
- 子宫切除术与尿失禁的可能性增加有关,特别是在老年妇女中.
- 在对子宫切除术的患者咨询中,应讨论这种潜在的后果.
- 术后多年内可能出现失禁风险,这凸显了长期后续讨论的重要性.
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