Frequency and Risk Factors of Urinary Incontinence After Hysterectomy

Year 2021, Volume: 74 Issue: 3, 300 - 303, 31.12.2021

Batuhan Turgay , Ayşe Filiz Yavuz

Abstract

Objectives: To determine the frequency of urinary incontinence developing after different types of hysterectomies performed for benign indications
and the possible risk factors associated with this condition.

Materials and Methods: Data of women who undergone hysterectomies for benign indications during one-year period were analyzed retrospectively.
Women who stated to have urinary incontinence in the twelve-month postoperative follow-up were defined as the case group. Women who did
not have urinary incontinence were the control group. Risk factors associated with urinary incontinence developing after hysterectomy were
determined by multiple regression analysis.

Results: After 300 total hysterectomies performed in a twelve-month period, urinary incontinence was detected in 44 (14.7%) women. Age over 60
years, menopause, obesity and presence of >2 grade pelvic organ prolapse were determined as significant independent factors for the development
of urinary incontinence after hysterectomy. The type of hysterectomy (abdominal, vaginal, or laparoscopic) was not a risk factor.

Conclusion: Urinary incontinence after hysterectomy can be seen with considerable frequency. Regardless of the type of hysterectomy, it is more
likely to be seen in the presence of age over 60 years, menopause, obesity, and severe prolapse.

Keywords

Hysterectomy , Urinary Incontinence , Risk Factor

Ethical Statement

Ethics Committee Approval: This study is approved by the Academic Board of Ankara Yıldırım Beyazıt University Faculty of Medicine, Department of Obstetrics and Gynecology (number: 2021-07-01).

Supporting Institution

-

Project Number

-

Thanks

-

Histerektomi Sonrası Üriner İnkontinansın Görülme Sıklığı ve Risk Faktörleri

Abstract

Amaç: Benign endikasyonlar için yapılan farklı histerektomi tiplerinden sonra gelişen üriner inkontinans sıklığını ve bu durumla ilişkili olası risk
faktörlerini belirlemek.

Gereç ve Yöntem: Bir yıllık süre içinde benign endikasyon nedeni ile histerektomi uygulanan kadınların verileri retrospektif olarak incelendi. Olgu
grubu olarak postoperatif on iki aylık takipte üriner inkontinansı olduğunu belirten kadınlar belirlendi. Üriner inkontinansı olmayan kadınlar kontrol
grubu olarak belirlendi. Histerektomi sonrası gelişen üriner inkontinans ile ilişkili risk faktörleri çoklu regresyon analizi ile incelendi.

Bulgular: On iki aylık sürede yapılan 300 total histerektomi sonrası 44 (%14,7) kadında idrar kaçırma tespit edildi. Altmış yaş üstünde olmak,
menapoz, obezite ve >2 derece pelvik organ prolapsusu varlığı histerektomi sonrası üriner inkontinans gelişimi için önemli bağımsız faktörler olarak
belirlendi. Histerektomi tipi (abdominal, vajinal veya laparoskopik) bir risk faktörü değildi.

Sonuç: Histerektomi sonrası üriner inkontinans sıklığı dikkate değer oranlardadır. Histerektominin türü ne olursa olsun, 60 yaş üstü, menapoz,
obezite ve şiddetli prolapsus varlığında görülme olasılığı daha yüksektir.

Keywords

Histerektomi , Üriner İnkontinans , Risk Faktör

Ethical Statement

Ethics Committee Approval: This study is approved by the Academic Board of Ankara Yıldırım Beyazıt University Faculty of Medicine, Department of Obstetrics and Gynecology (number: 2021-07-01).

Supporting Institution

-

Project Number

-

Thanks

-

References

• 1. Atakul T, Tayyar AT, Küçük M, et al. Comparison of de novo urinary incontinence after abdominal and vaginal hysterectomy. Ann Ital Chir. 2019;90:328-243.
• 2. Kudish BI, Shveiky D, Gutman RE, et al. Hysterectomy and urinary incontinence in postmenopausal women. Int Urogynecol J. 2014;25:1523- 1531.
• 3. Milsom I, Gyhagen M. The prevalence of urinary incontinence. Climacteric. 2019;22:217-222.
• 4. Irwin GM. Urinary Incontinence. Prim Care. 2019;46:233-242.
• 5. Kruse AR, Jensen TD, Lauszus FF, et al. Changes in incontinence after hysterectomy. Arch Gynecol Obstet. 2017;296:783-790.
• 6. Harendarczyk L, Cardaillac C, Vaucel E, et al. Impact de l’hystérectomie sur l’incontinence urinaire : revue de la littérature [Impact of hysterectomy on urinary incontinence: A systematic review]. Prog Urol. 2020;30:1096-1117.
• 7. Humalajärvi N, Aukee P, Kairaluoma MV, et al. Quality of life and pelvic floor dysfunction symptoms after hysterectomy with or without pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol. 2014;182:16-21.
• 8. Bohlin KS, Ankardal M, Lindkvist H, et al. Factors influencing the incidence and remission of urinary incontinence after hysterectomy. Am J Obstet Gynecol. 2017;216:53.e1-53.e9.
• 9. Brown JS, Sawaya G, Thom DH, et al. Hysterectomy and urinary incontinence: a systematic review. Lancet. 2000;356:535-539.
• 10. Altman D, López A, Falconer C, et al. The impact of hysterectomy on lower urinary tract symptoms. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14:418-423.
• 11. Gustafsson C, Ekström A, Brismar S, et al. Urinary incontinence after hysterectomy--three-year observational study. Urology. 2006;68:769-774.
• 12. Thakar R, Ayers S, Clarkson P, et al. Outcomes after total versus subtotal abdominal hysterectomy. N Engl J Med. 2002;347:1318-1325.
• 13. Lethaby A, Mukhopadhyay A, Naik R. Total versus subtotal hysterectomy for benign gynaecological conditions. Cochrane Database Syst Rev. 2012;CD004993.
• 14. Skorupska KA, Miotła P, Kubik-Komar A, et al. Urinary incontinence after hysterectomy- does type of surgery matter? Ginekol Pol. 2016;87:94-97.
• 15. Lakeman MM, van der Vaart CH, Roovers JP; HysVA study group. Hysterectomy and lower urinary tract symptoms: a nonrandomized comparison of vaginal and abdominal hysterectomy. Gynecol Obstet Invest. 2010;70:100-106.
• 16. Forsgren C, Lundholm C, Johansson AL, et al. Vaginal hysterectomy and risk of pelvic organ prolapse and stress urinary incontinence surgery. Int Urogynecol J. 2012;23:43-48.
• 17. Altman D, Granath F, Cnattingius S, et al. Hysterectomy and risk of stress-urinary-incontinence surgery: nationwide cohort study. Lancet. 2007;370:1494-1499.
• 18. Müller A, Thiel FC, Renner SP, et al. Hysterectomy-a comparison of approaches. Dtsch Arztebl Int. 2010;107:353-359. 19. Schreiber Pedersen L, Lose G, Høybye MT, et al. Prevalence of urinary incontinence among women and analysis of potential risk factors in Germany and Denmark. Acta Obstet Gynecol Scand. 2017;96:939-948.
• 20. Yan W, Li X, Sun S, et al. [Risk factors for female pelvic organ prolapse and urinary incontinence]. Zhong Nan Da Xue Xue Bao Yi Xue Ban. Journal of Central South University Medical Sciences. 2018;43:1345-1350.