BACKGROUND: Several gynecological conditions associated with hysterectomy, including @entity2371 , have been observed at increased rates in @entity1 who have experienced @entity458 . Previous findings have suggested that one of the unique health care needs for female military veterans may be an increased prevalence of hysterectomy and that this increase may partially be due to their higher risk of @entity458 history and @entity1005 ( @entity1005 ). Although associations between @entity130 , @entity1005 , and gynecological symptoms have been identified, little work has been done to date to directly examine the relationship between @entity458 , @entity1005 , and hysterectomy within the rapidly growing female veteran population. OBJECTIVES: The objective of the study was to assess the prevalence of hysterectomy in premenopausal-aged female veterans, compare with general population prevalence, and examine associations between hysterectomy and @entity458 , @entity1005 , and gynecological symptoms in this veteran population. STUDY DESIGN: We performed a computer-assisted telephone interview between July 2005 and August 2008 of 1004 female Veterans Affairs (VA)-enrolled veterans  <= 52 years old from 2 Midwestern US Veterans Affairs medical centers and associated community-based outreach clinics. Within the veteran study population, associations between hysterectomy and @entity458 , @entity1005 , and gynecological symptoms were assessed with bivariate analyses using   (2), Wilcoxon-Mann-Whitney, and Student t tests; multivariate logistic regression analyses were used to look for independent associations. Hysterectomy prevalence and ages were compared with large civilian populations represented in the Behavioral Risk Factor Surveillance System and American College of Surgeons National Surgical Quality Improvement Program databases from similar timeframes using   (2) and Student t tests. RESULTS: Prevalence of hysterectomy was significantly higher (16.8% vs 13.3%, P  = .0002), and mean age at hysterectomy was significantly lower (35 vs 43 years old, P < .0001) in this VA-enrolled sample of female veterans compared with civilian population-based data sets. Sixty-two percent of subjects had experienced attempted or completed @entity458 in their lifetimes. A history of completed lifetime @entity458 with vaginal penetration (LSA-V) was a significant risk factor for hysterectomy (age-adjusted odds ratio, 1.85), with those experiencing their first LSA-V in childhood or in military at particular risk. A history of @entity1005 was also associated with hysterectomy (age-adjusted odds ratio, 1.83), even when controlling for LSA-V. These associations were no longer significant when controlling for the increased rates of gynecological @entity158 , and pelvic @entity32 seen in those veterans with a history of LSA-V. CONCLUSION: Premenopausal-aged veterans may be at higher overall risk for hysterectomy, and for hysterectomy at younger ages, than their civilian counterparts. Veterans who have experienced completed @entity458 with vaginal penetration in childhood or in military and those with a history of @entity1005 may be at particularly high risk for hysterectomy, potentially related to their higher risk of gynecological symptoms. If confirmed in future studies, these findings have important implications for @entity1 's health care providers and policy makers within both the VA and civilian health care systems related to primary and secondary prevention, costs, and the potential for increased chronic disease and mortality.

Hysterectomy risk in premenopausal-aged military veterans: associations with XXXX and gynecologic symptoms.

@entity1 :: ('9606', 'Species') :: ['women'] @entity32 :: ('MESH:D007249', 'Disease') :: ['inflammatory disease'] @entity2371 :: ('MESH:D017699', 'Disease') :: ['abnormal bleeding and pelvic pain'] @entity458 :: ('MESH:D020018', 'Disease') :: ['sexual assault'] @entity1005 :: ('MESH:D013313', 'Disease') :: ['posttraumatic stress disorder', 'PTSD'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain, abnormal gynecological bleeding'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity458 :: (MESH:D020018,Disease) :: ['sexual assault']
