Incidence and remission of urinary incontinence after hysterectomy--a 3-year follow-up study

The aim of the study is to investigate the changes in continence status in a population of women hysterectomized in 1998-2000. Four hundred fifteen hysterectomized women who participated in a questionnaire study on continence status in September 2001 were retested with the same questionnaire on actual continence status in January 2005. As controls we used 97 women who had a laparoscopic cholecystectomy in 1999-2000 and were tested and retested similarly. Urinary incontinence was defined as involuntary urinary leakage at least once a week. Stress incontinence was defined as leakage when coughing, laughing, or lifting heavy weights. Urge incontinence was defined as an uncontrollable desire to void with leakage before reaching the toilet. Stress incontinence was reported by 30% of the hysterectomized women in 2005 vs 28% in 2001. The similar prevalences of urge incontinence were 15 and 13%, respectively. Women who had a subtotal hysterectomy significantly more often had stress incontinence compared to controls in 2005 and 2001. No other significant differences were found. However, the similar prevalences of incontinence reflected that 16% of the hysterectomized women changed from continent in 2001 to stress incontinent in 2005, while 32% changed from stress incontinent to continent. For urge incontinence the similar changes were 8 and 35%, respectively. A large proportion of women change from continent to incontinent or from incontinent to continent during the 3 years of investigation, which should be born in mind when prevalence studies on urinary incontinence are evaluated. Previous hysterectomy does not seem to be of great importance for the development of de novo incontinence or remission.