Relationship between hysterectomy and severity of female stress urinary incontinence

Abstract

BackgroundStress Urinary Incontinence (SUI) is one of the most reported health dilemmas of women suffering from lower urinary tract symptoms.AimTo determine the relation between hysterectomy and severity of female SUI using Valsalva Leak Point Pressure (VLPP).MethodsThis case-control study was conducted at a public urology clinic in Tehran in 2015. The study population was all female with SUI complaints who visited the clinic during 2015. We compared Valsalva leak point pressure in two groups of female SUI patients with and without hysterectomy history. The inclusion criteria were: not taking any alpha-blocker or anti-cholinergic medicines two weeks prior to the urodynamic test as well as no history of pelvic surgery or cesarean delivery in their lifetime. All qualified patients were invited to participate in the study randomly, and among them, 120 qualified patients agreed to participate by filling out the informed consent form. Data was gathered through direct interview, and double checked by patients’ medical records. All the study variables including age, BMI, delivery number, hysterectomy and UTI history were entered and analyzed by estimating ordered logistic regression and by using Stata14.1 software.ResultsThe mean of VLPP was 70.17 cmH2O in the group with hysterectomy history, and 94.55 cmH2O in those without hysterectomy history. The difference of VLPP pressure between the two studied groups were significant (p<0.05), even after control of confounding variables. Also, the odds of severe SUI among hysterectomy group patients was 6.3 times more than no hysterectomy (OR=6.32, p<0.001).ConclusionsOur study confirms significant relation between hysterectomy and SUI severity measured by Valsalva leak point pressure. Hysterectomy patients are more likely to suffer from more severe grades of SUI.

Função sexual e incontinência urinária por esforço em mulheres submetidas à histerectomia total com ooforectomia bilateral

“…Twenty-four (57%) out of them belong to THBOG and 18 (43%) to CG. Regarding the total number of participants in THBOG, 35.3% had symptoms of SUI. In CG, in turn, SUI was found in 19.1% of the women.…”

“…Since these tissues are sensitive to estrogen and are related to urinary continence, it is likely that their deficiency can lead to urinary incontinence 34 . Although some authors 13,35 confirm this association, others report a significant reduction in urinary disorders after hysterectomy due to the disappearance of urogenital pressure problems caused by benign conditions, especially in patients with large uterine sizes 23,36 . Although SUI does not represent a direct risk to life, it is a condition that can have serious medical, social, psychological and economic implications, affecting quality of life and sexuality 37 .…”

Do future healthcare professionals have adequate knowledge about risk factors for stress urinary incontinence in women?

“…Hysterectomy—due to static disorder of genital organs [ 31 ]. Radiation—atrophic changes in vascularization of the lower part of the urinary system have been demonstrated which might lead to urinary incontinence and which result from pelvic radiotherapy due to e.g.…”

Effects of Total Abdominal Hysterectomy and Total Laparoscopic Hysterectomy on Urinary Tract Dysfunction

“…In most studies, laparoscopic hysterectomy is a better choice than abdominal hysterectomy for more favorable causes such as less blood loss, less hospitalization, and healing period and also less postoperative pain. [ 4 5 6 7 8 9 10 11 12 13 16 17 18 19 20 ] In addition, laparoscopic hysterectomy techniques differ a little from conventional techniques. Endopelvic fascia and other supporter tissue of the bladder are more intact because the uterosacral ligament is more proximally resected.…”

“…The risk of urinary incontinence in patients with a history of hysterectomy increases significantly. [ 7 ] Elevated residual urine volume may be the predisposing factor for all symptomatic conditions such as intermittent urination, difficulty in urination, feeling of fullness, urinary infection, overflow, and stress incontinence. Furthermore, previous studies reported the beneficial effects of simple (nonradical) hysterectomy on urinary functions being of most concern.…”