Examining the risk of urinary incontinence after hysterectomy

This study examined risk factors on the incidence of urinary incontinence (UI) after hysterectomy. Researchers reported that some women developed UI after hysterectomy and some women with previous UI had a remission of symptoms. Researchers concluded that factors such as child delivery method, obesity, and uterus size can affect both outcomes.

Urinary incontinence (UI) has been linked to prior hysterectomy. Hysterectomy is a surgical procedure to remove a woman’s uterus. The uterus can be removed through an incision in the abdomen or the vagina. A hysterectomy may be necessary for a variety of reasons.

Some studies are suggesting that hysterectomy can increase the risk of developing UI. However, hysterectomy has also been reported to cause remission (reduction) of UI. Identifying risk factors that impact the effect of hysterectomy on UI is important for women considering undergoing a hysterectomy.

The aim of this study was to examine factors that impact the incidence of UI after hysterectomy.

The records of 16,182 women undergoing hysterectomy were included in analysis. 70.6% of women did not have UI before the procedure. 29.4% of women did have UI symptoms before the procedure. The effects of lifestyle factors on UI incidence within 1 year after hysterectomy were calculated.

45.3% of women with UI before the procedure experienced a remission after hysterectomy. 54.7% of women with previous UI had the same symptoms after the procedure. 12.05% of women with no previous UI developed symptoms after hysterectomy.

The risk of developing UI after hysterectomy was 63% higher among women with a BMI (body mass index; a measure of body fat that takes weight and height into account) of 30 or more. The women who developed UI after the procedure more often had a smaller uterus (weighing less than 500 g). Vaginal child delivery (1 or more) increased the risk of developing UI by 40%. Women with daily urge (sudden and compelling desire to pass urine) without incontinence were 77% more likely to develop UI after the procedure.

A BMI under 25 increased the chances of remission of UI symptoms by 22%. Women who experienced remission were more likely to have a uterus weighing 300 g or more. The chances of remission were highest among women who underwent hysterectomy due to prolapse (slipping forward or down of internal organs). When the hysterectomy was performed vaginally, the chances of remission were reduced by 30% compared to abdominal hysterectomy.

No effect of age or smoking was observed on the incidences or remission of UI after hysterectomy.

Having developed UI after hysterectomy or unchanged UI symptoms significantly reduced the satisfaction with surgery. 93% of women with a remission of UI symptoms were satisfied with the procedure.

Researchers concluded that vaginal child delivery, obesity, and uterus size can affect the chances of UI occurring or disappearing after hysterectomy.

UI was analyzed using a questionnaire, which is often less accurate than an examination by a physician.