Is intrinsic sphincter deficiency a complication of simple hysterectomy?
OBJECTIVE
Intrinsic sphincter deficiency may cause disabling stress urinary incontinence. While some pelvic operations are implicated as a cause of this condition, simple hysterectomy for benign disease is not recognized as one of them. We evaluated the association of simple hysterectomy with intrinsic sphincter deficiency.


METHODS
We performed a case control study to assess the association of simple hysterectomy with intrinsic sphincter deficiency in a consecutive group of 387 incontinent women. From 1995 to 1997 we identified 67 patients with and 67 controls without a history of hysterectomy. Further comparison was done after forming a subgroup at low risk for intrinsic sphincter deficiency. All patients were evaluated by a fluoroscopic urodynamic technique and abdominal leak point pressure was determined.


RESULTS
Intrinsic sphincter deficiency was present in 48% of the 67 patients and 24% of the 67 controls. In the lower risk subgroup we noted this condition in 29 patients (52%) and 53 controls (21%).


CONCLUSIONS
In this population of incontinent women intrinsic sphincter deficiency, as diagnosed by low abdominal leak point pressure, appears to be a complication of simple hysterectomy.
Morgan
J L
JL
Royal Melbourne Hospital, University of Melbourne, Australia.
O'Connell
H E
HE
McGuire
E J
EJ
D000005:Abdomen; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D015994:Incidence; D008875:Middle Aged; D011312:Pressure; D020047:Rectocele / Q000150:complications; D012307:Risk Factors; D001745:Urinary Bladder Diseases / Q000209:etiology* / Q000503:physiopathology; D014546:Urinary Catheterization; D014550:Urinary Incontinence, Stress / Q000209:etiology* / Q000503:physiopathology; D014563:Urodynamics / Q000502:physiology