Is intrinsic sphincter deficiency a complication of simple hysterectomy?

Intrinsic sphincter deficiency may cause disabling stress urinary incontinence. While some pelvic operations are implicated as a cause of this condition, simple hysterectomy for benign disease is not recognized as one of them. We evaluated the association of simple hysterectomy with intrinsic sphincter deficiency.

We performed a case control study to assess the association of simple hysterectomy with intrinsic sphincter deficiency in a consecutive group of 387 incontinent women. From 1995 to 1997 we identified 67 patients with and 67 controls without a history of hysterectomy. Further comparison was done after forming a subgroup at low risk for intrinsic sphincter deficiency. All patients were evaluated by a fluoroscopic urodynamic technique and abdominal leak point pressure was determined.

Intrinsic sphincter deficiency was present in 48% of the 67 patients and 24% of the 67 controls. In the lower risk subgroup we noted this condition in 29 patients (52%) and 53 controls (21%).

In this population of incontinent women intrinsic sphincter deficiency, as diagnosed by low abdominal leak point pressure, appears to be a complication of simple hysterectomy.