Incidence and remission of urinary incontinence after hysterectomy—a 3-year follow-up study

Abstract

The aim of the study is to investigate the changes in continence status in a population of women hysterectomized in 1998-2000. Four hundred fifteen hysterectomized women who participated in a questionnaire study on continence status in September 2001 were retested with the same questionnaire on actual continence status in January 2005. As controls we used 97 women who had a laparoscopic cholecystectomy in 1999-2000 and were tested and retested similarly. Urinary incontinence was defined as involuntary urinary leakage at least once a week. Stress incontinence was defined as leakage when coughing, laughing, or lifting heavy weights. Urge incontinence was defined as an uncontrollable desire to void with leakage before reaching the toilet. Stress incontinence was reported by 30% of the hysterectomized women in 2005 vs 28% in 2001. The similar prevalences of urge incontinence were 15 and 13%, respectively. Women who had a subtotal hysterectomy significantly more often had stress incontinence compared to controls in 2005 and 2001. No other significant differences were found. However, the similar prevalences of incontinence reflected that 16% of the hysterectomized women changed from continent in 2001 to stress incontinent in 2005, while 32% changed from stress incontinent to continent. For urge incontinence the similar changes were 8 and 35%, respectively. A large proportion of women change from continent to incontinent or from incontinent to continent during the 3 years of investigation, which should be born in mind when prevalence studies on urinary incontinence are evaluated. Previous hysterectomy does not seem to be of great importance for the development of de novo incontinence or remission.

The effect of hysterectomy or levonorgestrel‐releasing intrauterine system on lower urinary tract symptoms: a 10‐year follow‐up study of a randomised trial

“…It seems likely that the duration of follow‐up plays an important role in the evaluation of outcomes 23,24 . Studies with a short follow‐up have not been able to demonstrate an increase in urinary incontinence after hysterectomy, 5,6,22 whereas results from studies with a longer follow‐up 7–9 are in line with our results showing increases in voiding difficulty, SUI, and use of medication for UI after hysterectomy. Thakar et al.…”

“…On the other hand, a recent randomised study concluded that neither total nor subtotal hysterectomy adversely affected pelvic organ function at 12 months 6 . Similarly, three other prospective studies did not find an increased risk of UI after hysterectomy 5,21,22 . It seems likely that the duration of follow‐up plays an important role in the evaluation of outcomes 23,24 .…”

Mixed urinary incontinence: continuing to confound?

“…De-novo symptoms of all types of incontinence were noted in all groups with no differences between them, indicating that factors other than hysterectomy should be considered. Another well crafted study studying women over a 3-year period [31] has reported similar findings, with as many reporting improvement in incontinence symptoms as those showing deterioration.…”

Electrosurgical bipolar vessel sealing versus conventional clamping and suturing for vaginal hysterectomy: a randomised controlled trial

“…Another explanation may be that follow up was too short to observe a significant difference. Other previous studies with a short follow up were also not able to demonstrate an increase in urinary symptoms after hysterectomy, 25–28 whereas studies with long‐term follow up did find increased urinary incontinence and voiding difficulties 6,29–31 …”