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At least 559 records · Page 31Linked to original sources
PubMed1997

Tubal sterilization and long-term risk of hysterectomy: findings from the United States collaborative review of sterilization. The U.S. Collaborative Review of Sterilization Working Group.

OBJECTIVE: To estimate the long-term probability of hysterectomy after sterilization according to demographic and clinical characteristics before the procedure. METHODS: We used a prospective, multi-center cohort study of 10,698 women undergoing tubal sterilization to examine the cumulative probability of hysterectomy up to 14 years after sterilization. Independent risk factors for subsequent hysterectomy were examined using the life-table approach and the Cox proportional hazards model. RESULTS: The cumulative probability of undergoing hysterectomy 14 years after sterilization was 17%. The highest long-term cumulative probabilities of hysterectomy occurred among women who, at the time of sterilization, reported a history of endometriosis (35%) or were older than 30 years and reported prolonged bleeding during menses (46%). Multivariate modeling demonstrated an independently increased risk of hysterectomy among women who, at the time of tubal sterilization, reported a history of heavy menstrual flow (relative risk [RR] 1.4; 95% confidence interval [CI] 1.1, 1.7), severe menstrual pain (RR 1.3; 95% CI 1.1, 1.6), bleeding of more than 7 days during menstrual cycles (RR 1.8; 95% CI 1.1, 2.8), pelvic inflammatory disease (RR 1.3; 95% CI 1.04, 1.7), ovarian cysts (RR 1.6; 95% CI 1.2, 2.0), endometriosis (RR 2.5; 95% CI 1.7, 3.9), or uterine leiomyomata (RR 2.7; 95% CI 2.0, 3.7). CONCLUSIONS: Although women with gynecologic disorders before tubal sterilization were at greater risk of hysterectomy during the 14 years after sterilization than were women without these disorders, the majority of sterilized women in both categories did not undergo subsequent hysterectomy.

Adolescent↗
PubMed1998

Higher hysterectomy risk for sterilized than nonsterilized women: findings from the U.S. Collaborative Review of Sterilization. The U.S. Collaborative Review of Sterilization Working Group.

OBJECTIVE: To compare the risk of hysterectomy among previously sterilized women and women whose husbands had undergone vasectomy, and to evaluate whether this risk differed by age at surgical procedure or by method of tubal occlusion. METHODS: Our study population comprised 7718 women enrolled in a prospective, multicenter cohort study between 1978 and 1986. After stratifying by the woman's age at surgical procedure, we used the life-table approach and adjusted hazards ratios to examine whether the relative risk of hysterectomy during the 5 years after enrollment differed between the 7174 women who had been sterilized and the 544 women whose husbands had undergone vasectomy. RESULTS: The 5-year cumulative probability of hysterectomy was 8% among the previously sterilized women and 2% among the women whose husbands had undergone vasectomy. Among women 34 years of age and younger at enrollment, sterilized women were 4.4 times as likely to have a hysterectomy as women whose husbands had undergone vasectomy (95% confidence interval [CI] 1.9, 10.0). Findings were similar for women 35 years of age and older (rate ratio = 4.6; 95% CI 1.4, 14.5). Each of the six most commonly used methods of tubal occlusion was associated with an increased risk of hysterectomy. CONCLUSION: Women undergoing tubal sterilization were more likely than women whose husbands underwent vasectomy to undergo hysterectomy within 5 years after sterilization, regardless of age at sterilization. An increased risk of hysterectomy was observed for each method of tubal occlusion.

Adult↗
PubMed2002

The York review--a systematic review of public water fluoridation: a commentary.

Following the election of the British government in May 1997, a policy document outlining proposals to improve the health of the nation was published. This document placed a major emphasis on reducing inequalities in health and recognised the continuing poor state of oral health in deprived communities. However, whilst acknowledging the benefits of water fluoridation as a caries preventive measure, the Department of Health suggested that most of the research had been carried out some years ago and furthermore, recognised that strong views were held both for and against fluoridation.

Cariostatic Agents↗