Urinary incontinence following subtotal and total hysterectomy: a systematic review

Abstract

Objective: To evaluate the best surgical approach for the female urinary incontinence. Methods: Systematic review conducted in MEDLINE ® Cochrane, EMBASE and LILACS database up to September 1 st , 2017. Articles were selected according to study type, type of intervention and outcomes. Articles were selected by more than one researcher based on title, abstract and full text. The SIGN checklist was used for bias assessment. Results: A total of 165 articles were retrieved from MEDLINE ® . Twenty-five studies were elected for full text reading, and 11 of them were selected for the final text analysis. The heterogeneity between questionnaires used in different studies precluded a meta-analysis of results. Conclusion: This study yielded evidences supporting the hypothesis that total and subtotal hysterectomy have different impacts on urinary function of patients with benign uterine diseases. Articles revealed higher frequency of urinary incontinence following subtotal compared to total hysterectomy.

Impact of Hysterectomy on Quality of Life, Urinary Incontinence, Sexual Functions and Urethral Length

“…Altman et al, in a cohort study, found no correlation between the incidence of UI and the type of hysterectomy [27]. However, a systematic review by Longo et al revealed a higher frequency of UI after subtotal hysterectomy compared to total hysterectomy [28]. Moreover, the patient's satisfaction with the surgery and impact of hysterectomy on UI is strongly connected to other factors, such as the number of vaginal deliveries, being overweight, and daily urge symptoms without incontinence prior to the operation-which has a negative influence on the rate of remission of UI after hysterectomy [29].…”

Evaluation and conservative management of urinary incontinence in women

“…Working with individuals to reduce modifiable risk factors may improve continence. [5][6][7][8][9][10]…”

Incontinencia urinaria: causas y cuidados de enfermería. Una revisión bibliográfica

“…Para el tratamiento de la IU no neurogénica y en hombres tras prostatectomía retropúbica radical, se muestra como una opción fiable, eficiente, satisfactoria y segura, el esfínter artificial; ya que se produce una mejoría tanto de la calidad de vida, como del mantenimiento del flujo urinario evitando pérdidas de orina y síntomas obstructivos derivados de la intervención. El nivel de satisfacción de esta técnica se ve incrementado con características del paciente tales como la juventud y el alto nivel de actividad física [21][22][23][24][25] .…”