Abdominal hysterectomy - risk factor in development of urinary incontinence? Results of a questionnaire study
Abstract
Objective: To evaluate the risk of urinary incontinence development after abdominal hysterectomy for benign gynecological disease. Design: Retrospective questionnaire study.
Setting: Obstetrics and Gynecology Department, Charles University 2nd Medical Faculty and Teaching Hospital Motol, Prague. Methods: Questionnaire study of women in which abdominal hysterectomy for benign gynecological disease was performed from January till December 2001 at our Department of Gynecology and Obstetrics.
The questionnaire included questions about symptoms of stress, urge and mixed urinary incontinence. They were evaluated in connection with age, parity, hormonal status and body mass index.
Student t-test was used for the statistical analysis. Results: 114 (59.7 %) from all sent-out questionnaires were obtained.
In 15.8 % cases (18 from 114) de novo urinary incontinence after surgery developed. 77.8 % (14 from 18) from these patients suffered from gennuine stress incontinence. The rest (4 from 18) of the women had symptoms of mixed incontinence.
Study results draw attention to 13.1 % women (15 from 114) in which preoperative stress incontinence persisted even after hysterectomy. Preoperative stress incontinence was cured in 6.1 % (7 from 114) cases after hysterectomy.
Age, parity, hormonal status and body mass index were not statistically different in all groups after surgery. Conclusions: The results of the study show relatively high risk of urinary incontinence development after abdominal hysterectomy in previously continent women.
The results also show high persistence of the stress incontinence symptoms in women who did not inform about their incontinence even if they were asked about it. Higher quality of further health education of the women with drawing their attention to both the possibility of surgical treatment of urinary incontinence simultaneously with hysterectomy are the most important aspects how to make the current gynecological surgical therapy more effective.