子宫切除是一种常见的妇科手术，但其长期影响仍未得到充分研究。盆腔器官脱垂会显著降低生活质量。终生经历盆腔器官脱垂手术的风险为20％，而生育次数被认为是最大的风险因素。研究表明，在子宫切除术后，盆腔器官脱垂手术风险增加了，但很少有研究涉及哪些区域会受到影响，以及手术方式和生育次数如何影响这种关联。在这项丹麦全国性的队列研究中，我们确定了生于1947-2000年，并在1977-2018年间接受子宫切除的妇女，从子宫切除日开始索引。我们排除了在15岁以上移民的妇女、索引前接受盆腔器官脱垂手术的妇女以及在索引前或30天内被诊断出妇科癌症的妇女。对于年龄和子宫切除年份，我们将接受子宫切除的妇女与参考妇女进行了1：5的匹配。妇女在死亡、移民、妇科癌症诊断、根治或未指定的子宫切除或2018年12月31日中的任何一种情况下均停止计数。根据年龄、日历年、生育次数、收入和教育水平进行调整的Cox比例风险比（HR）和95％置信区间（CI）计算了子宫切除后盆腔器官脱垂手术的风险。我们包括了80,444名接受子宫切除的妇女和396,303名参考妇女。接受子宫切除的妇女进行盆腔器官脱垂手术的风险明显增加：HRadjusted 1.4（95％CI 1.3-1.5）。特别是后腔器官脱垂手术的风险增加：HRadjusted 2.2（95％CI 2.0-2.3）。生育次数越多，接受子宫切除后的脱垂手术风险就越高，增加了40％。剖腹产似乎不会增加脱垂手术的风险。这项研究表明，无论手术方式如何，子宫切除都会导致盆腔器官脱垂手术的风险增加，特别是在后腔。脱垂手术的风险随着阴道分娩次数的增加而增加，而非剖腹产。在选择治疗良性妇科疾病时，应仔细告知妇女盆腔器官脱垂的风险，应考虑其他治疗选项，特别是那些分娩次数很多的妇女。 ©2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica 由John Wiley＆Sons Ltd代表北欧妇产科协会（NFOG）出版。

Hysterectomy is a frequently performed gynecological procedure but long-term effects remain understudied. Pelvic organ prolapse reduces life quality significantly. The lifetime risk of undergoing pelvic organ prolapse surgery is 20% and parity is known to be the largest risk factor. Studies have shown an increased risk of pelvic organ prolapse surgery after hysterectomy; however, few have studied the compartments which are affected and how this association is affected by surgical route and parity.In this Danish nationwide cohort study, we identified women born in 1947-2000 who underwent hysterectomy during 1977-2018 who were indexed on the day of hysterectomy. We excluded women who immigrated when older than 15 years, who underwent pelvic organ prolapse surgery prior to index, and who were diagnosed with a gynecological cancer prior to or within 30 days of index. Women who underwent hysterectomy were matched 1:5 to references on age and year of hysterectomy. Women were censored at the time of death, emigration, a gynecological cancer diagnosis, radical or unspecified hysterectomy or December 31, 2018, whichever came first. The risk of pelvic organ prolapse surgery after hysterectomy was computed using Cox proportional hazard ratios (HRs) with 95% confidence intervals (CIs), adjusted for age, calendar year, parity, income and educational level.We included 80 444 women who underwent hysterectomy and 396 303 reference women. Women who underwent hysterectomy had a significantly higher risk of undergoing pelvic organ prolapse surgery: HRadjusted  1.4 (95% CI 1.3-1.5). In particular, the risk of a posterior compartment prolapse operation was increased: HRadjusted 2.2 (95% CI 2.0-2.3). The risk of prolapse surgery increased with increased parity and by an additional 40% after hysterectomy. Cesarean sections did not seem to increase the risk of prolapse surgery.This study shows that hysterectomy, regardless of surgical route, leads to an increased risk of pelvic organ prolapse surgery, especially in the posterior compartment. The risk of prolapse surgery increased with the number of vaginal births, and not cesarean sections. Women should be thoroughly informed about the risk of pelvic organ prolapse and other treatment options should be considered before choosing hysterectomy to treat benign gynecological diseases -particularly women who have had numerous vaginal births.© 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).