Our Summary

This research paper aimed to understand whether undergoing a hysterectomy (surgery to remove a woman’s uterus) increases the risk of developing urinary incontinence (UI - the lack of voluntary control over urination). The study was based on a group of women born in Northern Finland in 1966. Out of this group, 461 women who had hysterectomies were identified and compared to a reference group of 3495 women who did not have the surgery. The study then looked at the incidence of UI in these two groups.

The results showed that there was no significant difference in the occurrence of UI between women who had a hysterectomy and those who did not. The type of hysterectomy (laparoscopic, vaginal, or abdominal) also did not significantly affect the risk of UI. However, the study found that preexisting conditions like pelvic organ prolapse (a condition where a pelvic organ, such as your bladder, drops from its normal place and pushes against the walls of your vagina), could increase the risk of developing UI after a hysterectomy.

In simple terms, this research suggests that having a hysterectomy does not independently increase the risk of urinary incontinence. Instead, other conditions like pelvic organ prolapse might be responsible for the increased risk.

FAQs

  1. Does undergoing a hysterectomy increase the risk of developing urinary incontinence?
  2. Does the type of hysterectomy (laparoscopic, vaginal, or abdominal) affect the risk of urinary incontinence?
  3. Can preexisting conditions like pelvic organ prolapse increase the risk of developing urinary incontinence after a hysterectomy?

Doctor’s Tip

A helpful tip a doctor might give a patient about hysterectomy is to discuss any preexisting conditions like pelvic organ prolapse with your healthcare provider before undergoing the surgery. This can help to identify and address any potential risk factors for developing urinary incontinence post-hysterectomy. Additionally, following a proper post-operative care plan, including pelvic floor exercises and maintaining a healthy weight, can help reduce the risk of UI after surgery.

Suitable For

Therefore, patients who are recommended for a hysterectomy are typically those who have conditions that necessitate the removal of the uterus, such as:

  1. Uterine fibroids: Non-cancerous growths in the uterus that can cause pain, heavy menstrual bleeding, and other symptoms.

  2. Endometriosis: A condition where the tissue that lines the uterus grows outside of it, causing pain and other symptoms.

  3. Uterine prolapse: When the uterus slips down into the vagina due to weakened pelvic floor muscles.

  4. Gynecologic cancers: Including cancers of the uterus, cervix, or ovaries.

  5. Chronic pelvic pain: Persistent pain in the pelvic region that does not have a clear cause.

It is important for patients considering a hysterectomy to discuss the potential risks and benefits with their healthcare provider to determine if the procedure is the best option for their individual situation.

Timeline

Before a hysterectomy, a patient may experience symptoms such as pelvic pain, heavy menstrual bleeding, fibroids, endometriosis, or adenomyosis. They may have tried other treatment options such as medication or hormone therapy before deciding to undergo surgery. The patient will have consultations with their healthcare provider to discuss the risks and benefits of the procedure, as well as any potential alternatives.

After a hysterectomy, the patient will undergo a recovery period where they may experience pain, fatigue, and vaginal bleeding or discharge. They will need to follow post-operative care instructions, such as avoiding heavy lifting and sexual activity for a period of time. The patient may also experience emotional changes and adjustments to their body and reproductive health.

In the long term, the patient may experience changes in their menstrual cycle, hormonal balance, and sexual function. They may also need to adjust to the absence of their uterus and cope with any emotional or psychological effects of the surgery. Overall, the patient’s quality of life may improve if the hysterectomy successfully alleviates their initial symptoms and conditions.

What to Ask Your Doctor

Questions a patient should ask their doctor about hysterectomy in relation to urinary incontinence may include:

  1. What is the risk of developing urinary incontinence after undergoing a hysterectomy?
  2. Are there any specific factors or preexisting conditions that may increase my risk of developing urinary incontinence post-hysterectomy?
  3. How can I reduce my risk of urinary incontinence after the surgery?
  4. What are the different types of hysterectomy procedures, and do they have different impacts on the risk of urinary incontinence?
  5. Are there any alternative treatments or preventative measures I can consider to minimize the risk of urinary incontinence post-hysterectomy?
  6. What are the symptoms of urinary incontinence that I should be aware of, and when should I seek medical attention if I experience them?
  7. Are there any specific exercises or lifestyle changes I can make to improve my pelvic floor health and reduce the risk of urinary incontinence after a hysterectomy?
  8. How often should I schedule follow-up appointments to monitor my pelvic health and address any concerns related to urinary incontinence?

Reference

Authors: Salo H, Manninen R, Terho A, Laru J, Sova H, Koivurova S, Rossi HR. Journal: Acta Obstet Gynecol Scand. 2024 Oct;103(10):2061-2069. doi: 10.1111/aogs.14904. Epub 2024 Jul 29. PMID: 39075796