Determinants of hysterectomy and oophorectomy in women attending menopauseclinics in Italy

Authors
De Aloysio, D Di Donato, P Giulini, NA Modena, B Cicchetti, G Comitini, G Gentile, G Cristiani, P Careccia, A Esposito, E Gigli, C Mandruzzato, G Petraglia, F Bertelli, F Del Frate, G Garofalo, S Marino, L Costa, MR Quaranta, S Bossi, CM Amantea, P Omodei, U Vaccari, M Luerti, M Repetti, F Zandonini, G Raspagliesi, F Dolci, F Zacchi, V Bennici, S Polizzotti, G Bottino, S Raffaelli, F Minervini, C Colombo, D Belloni, C Viani, A Cecchini, G Winkler, S Samaja, BA Pasinetti, E Penotti, M Malanetto, C Massobrio, M Campagnoli, C Dolfin, G Tartaglino, P Mossotto, D Pesando, P Pacilli, L Rattazzi, PD Arisi, E Gamper, M Salvatores, D Bocchin, E Stellin, G Meli, G Azzini, V Tirozzi, F Buoso, G Fraioli, R Marsoni, V Cetera, C Sposetti, R Bellati, U Angeloni, C Buonerba, M Garzarelli, S Santilli, C Mucci, M Di Nisio, Q Falasca, L Ferrante, D Cirese, E Todaro, PA Romanini, C Spagnuolo, L Lanzone, A Donadio, C Fabiani, M Baldaccini, E Votano, S Serra, GB Bellardini, P Massacesi, L Donini, G Genazzani, RA Scarselli, G Curiel, P De Leo, V Melani, A D'Ancona, VL Giarre, G Di Gioia, E Ciccarelli, P Sarti, CD Balsotti, G Pupita, P Mincigrucci, M Spadafora, A Santeufemia, G D'Andrea, A Chiantera, A Montemagno, U Staiano, S Arienzo, R Pastore, AR Tamburrino, A Colacurci, A Izzo, S Zumpano, N Pascarella, A De Silvio, MG Di Prisco, L Lauda, N Sorrentino, O Agrimi, C Casarella, G Pisaturo, G Senatore, G Ruccia, G Fasolino, A Tropea, P Stigliano, CM Giannice, C Vadala, P Coco, A Lombardo, R Barese, G Masciari, G Pirillo, P Gioffre, T Ferruccio, C Agostinelli, D Tonti, GC Scopelliti, A Schonauer, S Bongiovanni, F Tinelli, F Poddi, ER Scarpello, F Colonna, L Fischetti, G Doria, R Trombetta, G Cocca, EB Carone, D Nocera, F Giambanco, V Giannola, C Graziano, R Mezzatesta, M Vegna, G Giannone, G Palumbo, G Cancellieri, F Mondo, A Cordopatri, A Carrubba, M Mazzola, V Ettore, G D'Asta, S Di Liberto, P",Angeloni,D'Andrea,Stigliano,Arienzo,"Di Donato",Giulini,Gigli,Ricci,Marino,Luerti,Donini,Dolfin,Poddi,Santeufemia,Nocera,Melani,Messini,Mincigrucci,Salvatores,Bocchin,"Massacesi, A Chiantera, A Sarti, CD De Aloysio, P Omodei, U Ognissanti, F Campagnoli, C Penotti, M Gambacciani, A Graziottin, A Baldi, C Parazzini, F Chatenoud, L Chiaffarino, F
Citation
D. De Aloysio et al., Determinants of hysterectomy and oophorectomy in women attending menopauseclinics in Italy, MATURITAS, 36(1), 2000, pp. 19-25
Citations number
31
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Reproductive Medicine","Medical Research General Topics
Journal title
MATURITAS
ISSN journal
0378-5122 → ACNP
Volume
36
Issue
1
Year of publication
2000
Pages
19 - 25
Database
ISI
SICI code
0378-5122(20000731)36:1<19:DOHAOI>2.0.ZU;2-5
Abstract
Objective : To analyse determinants of hysterectomy for benign uterine cond itions with or without oophorectomy in Italy, a country with among the lowe st rates of hysterectomy worldwide. Methods: Between 1997 and 1999, a large cross sectional study was conducted on the characteristics of women around menopause attending a network of first level outpatients menopause clinics in Italy for general counselling about menopause or treatment of menopausa l symptoms. A total of 25 644 women entered the study. Characteristics of w omen who underwent and women who did not undergo hysterectomy and oophorect omy were compared. Results: Out of the 25 644 women considered, 4727 were h ysterectomized (18.4%). Mean age at surgery was 46.8 years. The OR of hyste rectomy decreased with increasing educational level: in comparison with wom en with primary and none education, the OR of hysterectomy was 0.8 (95% CI 0.7- 0.9) and 0.6 (95% CI 0.5-0.7) respectively for women with intermediate or high/university degree. Body mass index (BMI, kg m(-2)) was related to the frequency of hysterectomy; in comparison with women with BMI less than or equal to 23.8, the OR of hysterectomy was 1.2 (95% CI 1.1-1.3) and 1.4 ( 95% CI 1.2-1.5) respectively for women with a BMI 23.8-27.2 and > 27.2. The frequency, of bilateral oophorectomy increased with age at hysterectomy: i n comparison with women who have had hysterectomy when aged less than or eq ual to 43 years, the OR of bilateral oophorectomy during hysterectomy was r espectively 1.9, 3.4 and 4.3 in women who had hysterectomy at age 44-47, 48 -51 and greater than or equal to 52 years. The Frequency of bilateral oopho rectomy was lower in more educated women: in comparison with women reportin g none or primary degree, the OR was 1.0 and 0.8 respectively for women wit h intermediate and high/university degree. Conclusions: The results of this analysis indicate that hysterectomy for benign conditions is more frequent ly performed in less educated women, in nulliparae and in women with higher BMI. During hysterectomy for benign conditions, bilateral oophorectomy is more frequent in less educated women and its frequency increases with women 's age. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.