Urethral closure function after total and subtotal hysterectomy measured by urethrocystometry

Area of Science:

• Urology
• Gynecology
• Female Pelvic Medicine

Background:

• Hysterectomy and supravaginal uterine amputation are common gynecological procedures.
• Stress urinary incontinence is a prevalent condition affecting women.
• The impact of these surgeries on urethral closure function requires investigation.

Purpose of the Study:

• To evaluate the effect of hysterectomy and supravaginal uterine amputation on urethral closure function.
• To assess changes in urethral closure pressure, functional length, and stress resistance post-surgery.

Main Methods:

• Urethral closure function was measured using urethrocystometry.
• Measurements were taken before and 3 months after hysterectomy (18 patients) or supravaginal uterine amputation (13 patients).
• Patients with and without pre-existing mild stress incontinence were included.

Main Results:

• No significant changes in urethral closure pressure at rest or under stress were observed after either surgical procedure.
• Functional urethral length, pressure transmission, urethral relaxation, and urethral resistance to stress remained unchanged.
• The incidence of mild stress incontinence symptoms decreased from 16 to 11 patients post-operation, but functional parameters did not correlate.

Conclusions:

• Hysterectomy and supravaginal uterine amputation do not adversely affect key parameters of urethral closure function.
• These gynecological surgeries appear safe concerning urethral continence mechanisms.
• Further research may explore the slight reduction in incontinence symptoms despite unchanged functional parameters.