Hysterectomy and incontinence: a study from the Swedish national register for gynecological surgery.
BACKGROUND
Hysterectomy is one factor that has been suggested to be a risk factor for developing stress incontinence. In Sweden, with a population of 8.86 million, a national register was set up in 1997 in order to have data for assessing the quality of gynecological surgery for benign disorders.


METHODS
Data in the Swedish national register for gynecological surgery during the period 1997-2002 were investigated. Surgical methods compared during this time period were: total hysterectomy (abdominal/laparoscopic, n=198/116), subtotal hysterectomy (abdominal/laparoscopic, n=163/86), and total hysterectomy (vaginal/laparoscopic assisted vaginal, n=265/7). Patients who underwent endometrial destruction (endometrial ablation, endometrial balloon treatment, n=187) were used as a control group. Only patients with no preoperative complaints were included. Outcome measures were answers to subjective questions asked pre- and postoperatively regarding urinary problems and incontinence.


RESULTS
De novo symptoms of stress incontinence, urgency and urgency incontinence, and/or mixed incontinence were noted in all groups. No differences were found among the groups.


CONCLUSIONS
Factors other than hysterectomy should be discussed causing stress incontinence in women.
Engh
Marie A Ellström
MA
Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden. marie.ellstrom@vgregion.se
Otterlind
Lena
L
Stjerndahl
Jan-Henrik
JH
Löfgren
Mats
M
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D012042:Registries; D013548:Sweden; D014549:Urinary Incontinence / Q000209:etiology*