Women undergoing hysterectomy are at nearly three times higher risk of developing stress urinary incontinence (SUI) compared to women who did not have a hysterectomy, suggests a recent study presented at the recently concluded American Urogynecologic Society (AUGS) and International Urogynecological Association (IUGA) Scientific Meeting held in Austin, Texas.¹

A total of 83,370 Danish women who underwent hysterectomy were matched with 413,969 women who did not undergo the procedure in a 1:5 ratio on the basis of age and year of surgery to investigate the risk of SUI after the hysterectomy. The study excluded women who had a tension-free vaginal tape (TVT) procedure within 2 weeks of the hysterectomy.

After analyzing the data, Husby et al found that the number of surgeries performed annually for stress urinary incontinence had increased during the study period. Women who had had hysterectomy had overall three times greater likelihood of surgery for SUI with a hazard ratio of 2.7. The percentage of women undergoing SUI surgery 30 years after the index date was 4.1%, while only 1.5% of women who did not have hysterectomy underwent surgery for SUI.

Multiparous women in both groups, especially those with a history of one or more vaginal births,  were at a higher risk of stress urinary incontinence and undergoing corrective surgery. In the hysterectomy group, women with one vaginal birth had a nearly 16% risk of SUI surgery, while in the non-hysterectomy group, this risk was nearly 6%. The number of cesarean sections also influenced the probability of SUI surgery in both groups.

Women undergoing hysterectomy should be cautioned about the risk of SUI and surgery for SUI to allow informed decision making. Extra care should be taken for multiparous women. The need for hysterectomy should be carefully considered and the risk of SUI must be always kept in mind, suggest the authors.

Reference

1. Christoffersen NM, et al. Increased risk of stress-urinary-incontinence surgery after hysterectomy–a population-based cohort study. Abstract 120. Female Pelvic Med Reconstr Surg. 2022 June;28 (6 Suppl 1):S68.