Uterus Removal Increases Risk of Incontinence

A new study has found that women who have had a hysterectomy are more than twice as likely to undergo surgery for urinary incontinence as women with an intact uterus.

Researchers at the Karolinska Institutet (Stockholm, Sweden) selected 165,260 women who had undergone hysterectomy (exposed cohort) and a control group of 479,506 individuals who had not had the procedure (unexposed cohort), matched by year of birth and county of residence. In both cohorts, occurrence of stress-urinary-incontinence surgery was established from the Swedish inpatient registry.

The study found that during the 30-year observational period, the rate of stress-urinary-incontinence surgery per 100,000 person-years was 179 in the exposed cohort versus 76 in the unexposed cohort, irrespective of surgical technique. The study found that highest likelihood of incontinence surgery was noted within five years of the removal of the uterus, but the higher risk remains throughout the patients' lives. The risk increased most for women who had a hysterectomy before their menopause or after having undergone several childbirth deliveries. The study was published in the October 27, 2007, issue of The Lancet.

"It's important that gynecologists take this into account ahead of a hysterectomy, and the patients should themselves be aware of the greater risk the operation entails, particularly if they belong to a high-risk group,” said co-author Daniel Altman, M.D., of the division of obstetrics and gynecology.

Hysterectomy is the most common gynecological abdominal operation in the world. It is normally performed as a cure for benign medical problems in order to improve life quality for the patients. However, the long-term effects are largely unknown, and it has long been suspected that the operation increases the risk of developing urinary incontinence, in many respects a very disabling condition that affects hundreds of thousands of women in Sweden.


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