Age and Hysterectomy Risk followingHysteroscopic Surgery for Abnormal Uterine Bleeding

Evidence based observation suggests that younger women face a higher risk of undergoing hysterectomy following hysteroscopic surgeries (HS) for abnormal uterine bleeding (AUB). The present study aimed to assess how age influences the likelihood of needing a hysterectomy after HS for AUB.

This nationwide, population-based retrospective cohort study included 4,150 women aged 40 years and older who were diagnosed with AUB and underwent HS between 2000 and 2020. The analysis employed the Cox proportional hazards model to evaluate hysterectomy outcomes, categorizing participants into three age groups: 40-44, 45-49, and 50-55 years. 

The results showed the following findings:

• The average age of the 4,150 participants was 46.1 years, classified into the following age groups: 40-44 years (39.6%), 45-49 years (38.8%), and 50-55 years (21.6%).
• About 8.1% of participants ultimately required a hysterectomy, with the highest rate in the 40-44 age group (8.6%). 
• The median time from HS to hysterectomy ranged from 0.25 to 2.78 years across age groups. 
• Notably, the presence of uterine myoma (adjusted hazard ratio [aHR]: 2.11; 95% CI: 1.70-2.64) and adenomyosis (aHR: 10.24; 95% CI: 8.17-12.85) significantly elevated the risk of hysterectomy. 
• Kaplan-Meier survival analysis indicated similar rates of hysterectomy across age groups within five years post-HS, with most cases occurring within this timeframe.

The study concluded that age did not significantly influence the likelihood of undergoing subsequent hysterectomy after HS. These findings enhance the understanding of HS outcomes and offers valuable information for patients considering surgical options for AUB.

Source: Huang WT, Wang JH, Ding DC. Age did not affect the rate of subsequent hysterectomy following hysteroscopic surgery: A population-based retrospective cohort study from 2000 to 2020. Int J Gynaecol Obstet. 2025 Jan 15. doi: 10.1002/ijgo.16162. Epub ahead of print. PMID: 39812158.