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Hysterectomy and incontinence: a study from the Swedish national register for gynecological surgery
Marie A Ellström Engh1, Lena Otterlind, Jan-Henrik Stjerndahl
1Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden. marie.ellstrom@vgregion.se
Background:
Hysterectomy is one factor that has been suggested to be a risk factor for developing stress incontinence. In Sweden, with a population of 8.86 million, a national register was set up in 1997 in order to have data for assessing the quality of gynecological surgery for benign disorders.
Methods:
Data in the Swedish national register for gynecological surgery during the period 1997-2002 were investigated. Surgical methods compared during this time period were: total hysterectomy (abdominal/laparoscopic, n=198/116), subtotal hysterectomy (abdominal/laparoscopic, n=163/86), and total hysterectomy (vaginal/laparoscopic assisted vaginal, n=265/7). Patients who underwent endometrial destruction (endometrial ablation, endometrial balloon treatment, n=187) were used as a control group. Only patients with no preoperative complaints were included. Outcome measures were answers to subjective questions asked pre- and postoperatively regarding urinary problems and incontinence.
Results:
De novo symptoms of stress incontinence, urgency and urgency incontinence, and/or mixed incontinence were noted in all groups. No differences were found among the groups.
Conclusion:
Factors other than hysterectomy should be discussed causing stress incontinence in women.
