Urinary incontinence after hysterectomy—three-year observational study

Background/Aims: The etiology of urge urinary incontinence is unknown. Pharmacological treatments are disappointing, since they are only slightly more effective than a placebo. In this study, we analyzed whether the surgical replacement of the uterosacral ligaments by an alloplastic tape can cure patients with mixed and urge urinary incontinence. Methods: This study was a nonrandomized clinical trial. The study was performed in the Department of Gynecology of a general hospital and a university clinic. 135 women with urge or mixed urinary incontinence were operated on. The utero-sacral ligaments as well as the pubo-urethral ligaments – if necessary – were replaced by alloplastic tapes. Clinical outcome was evaluated immediately after surgery, 3 months later and 1 year later. Outcome was classified as cure, improvement or failure and recurrences. Results: 102 patients (77%) were cured and a further 24 patients (18%) showed improvement after surgery. 19 patients developed a recurrence between 5 and 33 months after surgery. Conclusion: We therefore conclude that most patients with urge and mixed urinary incontinence can be cured by surgery.

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“…No patient had a uterine or vaginal prolapse grade 4. Two patients had a descensus grade 3 and 2 patients had grade 2 [6]. …”

Section: Resultsmentioning

confidence: 99%

“…Up to 50% of these patients suffer from urge urinary incontinence [4,5]. Descensus uteri is not a disease of the uterus, so it is not surprising that neither vaginal nor abdominal hysterectomy can cure urge urinary incontinence in these patients [6]. …”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of Mixed and Urge Urinary Incontinence in Women

Jäger

Mirenska

Brügge³

2012

Gynecol Obstet Invest

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“…In a study by El-Youkhy et al, an urodynamic assessment of hysterectomized patients six months after surgery revealed no detrimental effects and resolution of urinary dysfunction symptoms was observed [20]. As far as studies on long-term effects of hysterectomy are concerned, to the best of our knowledge, a three-year observational study by Gustafsson et al, has been the only long-term prospective study in the literature [21]. However, no urodynamic assessment was performed in that study as only patient symptoms were investigated and no significant differences were found for the frequency of urge incontinence, stress incontinence, or voiding patterns [21].…”

Section: Discussionmentioning

confidence: 99%

“…As far as studies on long-term effects of hysterectomy are concerned, to the best of our knowledge, a three-year observational study by Gustafsson et al, has been the only long-term prospective study in the literature [21]. However, no urodynamic assessment was performed in that study as only patient symptoms were investigated and no significant differences were found for the frequency of urge incontinence, stress incontinence, or voiding patterns [21]. As for the available literature, only a few studies address the factors affecting incontinence, in terms of the number of patients, length and methods of monitoring, etc.…”

Section: Discussionmentioning

confidence: 99%

Urodynamic assessment of short-term effects of pelvic radiotherapy on bladder function in patients with gynecologic cancers

Emirdar

Naykı²,

Ertaş³

et al. 2016

Ginekol Pol

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Objectives: To determine the short-term effects of adjuvant or primary curative radiotherapy (RT) on the urinary system in women with gynecologic cancer. Material and methods:This is a prospective, concurrent cohort study including 55 patients with gynecologic cancer who were divided into three groups. Group 1 included 10 patients who were administered adjuvant RT following a radical hysterectomy (RH); Group 2 included 36 patients who were administered adjuvant RT following a type 1 hysterectomy and Group 3 included 9 patients who were administered primary curative RT. Urogynecologic assessments were carried out on patients before and six months after the treatment.Results: Compared to pretreatment, no significant differences were observed in any of the three groups after treatment in terms of incontinence, first urge to urinate, normal urge to urinate, severe urge to urinate and changes in residual urine volumes. There was a significant decrease in maximal vesical pressure after treatment in Group 1 and Group 3. The maximum detrusor pressure decreased significantly in Group 1. The post-treatment decline in bladder capacity in Group 1 and Group 2 was also significant. Conclusions:RH and pelvic RT cause lower urinary system dysfunction. Especially patients who receive primary curative RT and patients who are administered RT after RH, where more pelvic denervation occurs, are at higher risk due to high doses of RT.

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“…Up to 50 % of these patients had UUI [9,10]. Descensus uteri is not a disease of the uterus, so it is not surprising that neither vaginal nor abdominal hysterectomy can cure UUI in these patients [11]. In 1996 Petros 'Integral Theory' pointed out the importance of the posterior compartment for establishing continence function [12].…”

Section: Introductionmentioning

confidence: 99%

Urge Urinary Incontinence And Pelvic Organ Prolapse Treatment By Cervicosacropexy (CESA): First Steps In Lithuania

et al. 2016

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Key words: cervicosacropexy (CESA), vaginosacropexy (VASA), urinary incontinence, overactive bladder syndrome, mixed urinary incontinence, polyvinylidene fluoride tape, uterosacral ligaments. SummaryBackground. The purpose of our study is to evaluate and present the results of the first cervicosacropexy (CESA) in Lithuania, which was performed in Klaipeda university hospital. Materials and methods. For the 62 years old female patient suffering from overactive bladder syndrome, confirmed by urodynamic test, and II⁰ pelvic organ prolapse (by pelvic organ prolapse quantification classification) cervicosacropexy using polyvinylidene fluoride (PVDF) tape was performed in Klaipeda University Hospital in 2016. Urinary incontinence was evaluated by voiding diary, International Consultation on Incontinence Modular Questionnaire -Short Form (ICIQ-SF) and Overactive Bladder Symptom Score (OABSS), that were filled by the patient before the surgery and 2, 4, 8 weeks after it. Urinary urgency, episodes of urinary incontinence, the need of sanitary pads and urinary frequency were compared before and after the surgery. To assess urinary incontinence impact on daily life, the General King's Health Questionnaire (GKHQ) was used before and after the procedure. Results. After the surgery decrease of episodes of urinary incontinence, urinary frequency during day and night, urinary urgency and the need of sanitary pads were observed. Moreover, the patient could hold the urine longer after feeling the need to urinate. IntroductionUrge urinary incontinence (UUI) is a bothersome urogenital disorder that affects approximately one third of postmenopausal women. Urgency, frequency and incontinence -this triad has detrimental effects on the patient's quality of life and proves to be a source of anxiety [1]. According to Herzog, Fultz and Thom, about 40 % of all women will develop urinary incontinence during their life, usually starting around the age of 50 [3,4]. This is a debilitating disorder, which massively restricts the social and private life of the patient [5]. Known pharmacological treatment attempts to reduce the urinary incontinence symptoms; however, there is no cure addressing the basic cause of the disease [6]. Moreover, pharmacological treatment is slightly more effective than placebo [7]. Treatment of UUI is now focused on antimuscarinic drug therapy, botulinum intravesical injection, sacral neuromodulation, and behavioral interventions [7]. Despite many known treatment methods of UUI, surgery is not widely practiced.Little is known about causes of UUI. Recent physiological and clinical researches are focused on descriptions and development of etiological theories. The most promising theories indicate abnormalities in control of bladder function resulting from aberrations of neurological signals from the bladder (sensation) as well as signals from continence controlling central and peripheral nervous system [7].In 1991 de Lancey emphasized the importance of the support of the genital tract for continence function [8]. He con...

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Urinary incontinence after hysterectomy—three-year observational study

Cited by 29 publications

References 32 publications

Surgical Treatment of Mixed and Urge Urinary Incontinence in Women

Surgical Treatment of Mixed and Urge Urinary Incontinence in Women

Urodynamic assessment of short-term effects of pelvic radiotherapy on bladder function in patients with gynecologic cancers

Urge Urinary Incontinence And Pelvic Organ Prolapse Treatment By Cervicosacropexy (CESA): First Steps In Lithuania

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