Hysterectomy associated with long-term risk for urinary symptoms

January 01, 0001

Hysterectomy associated with long-term risk for urinary symptoms

These Finish authors evaluated the effect of hysterectomy and levonorgestrel-releasing intrauterine system (LNG-IUS) on lower urinary tract symptoms (LUTS) among women treated for menorrhagia. The original study was a randomized controlled trial. Here they report long-term results at 10 years analysed by actual treatment rather than treatment allocataion. Medications and operations for urinary incontinence were confirmed from medical records and national registries.

They found: "Overall, 221 (94%) women took part in the 10-year follow- up evaluation. As 55 (46%) women originally randomised to the LNG-IUS group underwent hysterectomy, the results were analysed by actual treatment. Women treated by hysterectomy used more medication for urinary incontinence than LNG- IUS users (12% versus 1%). Three hysterectomised women and one LNG-IUS user underwent surgery for stress urinary incontinence (SUI). Women treated by hysterectomy had more urinary tract infections (UTIs) than LNG-IUS users (OR 3.20). Feeling of incomplete emptying (OR 3.00) and SUI (OR 1.83) were more common among women treated by hysterectomy. No differences between the study arms were noted in urge urinary incontinence or by the Urinary Incontinence Severity Score. A multivariate model showed that UTIs were associated with hysterectomy."

The authors concluded: "Hysterectomy increases the risks for incomplete emptying, lower UTIs and SUI."

These results add evidence to support less costly and invasive treatments for women with menorrhagia such as LNG-IUS.

For the full abstract, click here.

BJOG 602-609, April 2010
© 2010 to RCOG
The effect of hysterectomy or levonorgestrel-releasing intrauterine system on lower urinary tract symptoms: a 10-year follow-up study of a randomised trial. S Heliovaara-Peippo, K Halmesmäki, R Hurskainen et al. Correspondence to Dr. Heliovaara-Peippo: satu.heliovaara-peippo@helsinki.fi

Category: X. Female Genital System, Breast, U. Urinary System. Keywords: hysterectomy, levonorgestrel intrauterine system, LNG-IUS, lower urinary tract symptoms, menorrhagia, urinary incontinence, urinary tract infection, cohort follow-up of randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor April 13 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.