title: Urinary incontinence and hysterectomy in a large prospective cohort study in American women.
abstract: OBJECTIVE
  We investigated the effects of hysterectomy with and without concomitant urinary incontinence repair on incontinence severity in one of the largest prospective studies of hysterectomy outcomes performed in the United States.
  
  
  METHODS
  We administered the Urinary Symptoms Scale for Women to 1,299 women before hysterectomy done for benign conditions, and 6, 12, 18 and 24 months postoperatively to measure the presence, severity and type of urinary incontinence.
  
  
  RESULTS
  Before hysterectomy 29.5% of participants had severe urinary incontinence, which decreased to 10% 12 and 24 months after hysterectomy. Most women with severe incontinence before hysterectomy showed improved incontinence 1 year after surgery (89.1%) and were still improved after 2 years (86.5%). The majority of women with moderate incontinence before hysterectomy showed improved incontinence 1 year after surgery (62.4%) and were still improved after 2 years (61.2%). However, some women with mild or no incontinence before hysterectomy had new onset incontinence or the condition had worsened 1 year after surgery (16.7%) and was still worse after 2 years (14.4%). A concomitant urinary incontinence repair procedure significantly increased the probability that a woman with severe incontinence would have improved incontinence 1 year after hysterectomy and significantly decreased the probability that a woman with mild or no incontinence would have worse incontinence after 2 years.
  
  
  CONCLUSIONS
  The majority of women who undergo hysterectomy for nonmalignant indications experienced improved urinary incontinence during the first 2 years after surgery.
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore, Maryland 21201, USA.
authors.forename: Kristen H
authors.initials: KH
authors.lastname: Kjerulff
authors.forename: Patricia W
authors.initials: PW
authors.lastname: Langenberg
authors.forename: LaVonne
authors.initials: L
authors.lastname: Greenaway
authors.forename: Jane
authors.initials: J
authors.lastname: Uman
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Harvey
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011336:Probability; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome; D014481:United States; D014549:Urinary Incontinence / Q000453:epidemiology / Q000601:surgery*