title: Does mode of hysterectomy influence micturition and defecation?
abstract: OBJECTIVE
  Hysterectomy may affect bladder and bowel function. A retrospective study was performed to compare the prevalence of micturition and defecation symptoms between different modes of hysterectomy.
  
  
  METHODS
  All pre-operatively asymptomatic patients, with uteral size < or =10 cm, who underwent hysterectomy between 1988 and 1997 were interviewed about the prevalence of micturition and defecation symptoms and the experienced physical and emotional limitations of these symptoms. Using logistic regression analysis, odds ratios (OR) were calculated for all symptoms of which the prevalence between modes of hysterectomy differed more than 10%. These odds ratios were adjusted for differences in other prognostic factors.
  
  
  RESULTS
  Vaginal hysterectomy was performed on 68 patients, total abdominal hysterectomy on 109 patients and subtotal abdominal hysterectomy on 50 patients. An increased prevalence of urge incontinence (adjusted OR 1.5 (95% CI 0.8-3.1)) and feeling of incomplete evacuation (adjusted OR 1.9 (95% CI 1.0-4.0)) was observed among patients who had undergone vaginal hysterectomy as compared to patients who had undergone total abdominal hysterectomy. The prevalence of urge incontinence (adjusted OR 1.8 (95% CI 0.8-4.2)) and difficulty emptying the rectum (adjusted OR 1.8 (95% CI 0.7-4.4)) was higher among patients who had undergone vaginal hysterectomy than among patients who had undergone subtotal abdominal hysterectomy. Statistically significant odds ratios were not observed. Relevant differences in physical and emotional limitations related to micturition and defecation symptoms were not observed between groups.
  
  
  CONCLUSIONS
  Our results suggest that technique of hysterectomy may influence the prevalence of micturition and defecation symptoms following hysterectomy.
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Center, Utrecht, The Netherlands. J.P.Roovers@azu.nl
authors.forename: J P
authors.initials: JP
authors.lastname: Roovers
authors.forename: J G
authors.initials: JG
authors.lastname: van der Bom
authors.forename: C
authors.initials: C
authors.lastname: Huub van der Vaart
authors.forename: D M
authors.initials: DM
authors.lastname: Fousert
authors.forename: A P
authors.initials: AP
authors.lastname: Heintz
mesh_terms: D000328:Adult; D003672:Defecation / Q000502:physiology*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007045:Hysterectomy, Vaginal / Q000009:adverse effects*; D007410:Intestinal Diseases / Q000209:etiology* / Q000503:physiopathology; D008875:Middle Aged; D016017:Odds Ratio; D010043:Outcome and Process Assessment, Health Care; D017773:Pelvic Floor / Q000503:physiopathology; D012007:Rectum / Q000503:physiopathology; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D001743:Urinary Bladder / Q000503:physiopathology; D014555:Urination Disorders / Q000209:etiology* / Q000503:physiopathology