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September 17, 2021  
UTERINE NEWS: Feature Story

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  • Hysterectomy May Increase Risk of Incontinence

    Hysterectomy May Increase Risk of Incontinence

    December 03, 2007

    By: Laurie Edwards for Uterus1

    For the many American women with non-life threatening medical conditions who undergo hysterectomies, researchers may have found a complication worth considering. According to a new study, these women face a higher risk of developing urinary incontinence later in life that needs to be treated surgically.
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  • Since they remove tumors, hysterectomies are often necessary for treating cancer.
  • They may also be used to treat the following non-life threatening conditions: heavy menstrual or postmenopausal bleeding, endometriosis or uterine prolapse.
  • Drug therapies and minimally invasive procedures may be effective treatments.
  • Like any surgery, hysterectomies come with risks. These include reactions to anesthesia, bleeding, infection or injury to nearby organs.
  • Make sure you explore all available treatment options with your physician and should you decide that a hysterectomy is right for you, take time to ask questions and understand the risks.

  • Dr. Daniel Altman of the Karolinska Institutet Danderyd Hospital, Stockholm, and his colleagues found that the women with a history of hysterectomy faced a 2.4 times higher risk of developing incontinence and having stress-urinary-incontinence surgery (SUIS) than women who hadn’t had hysterectomies.

    Hysterectomies are surgeries that remove all or part of the uterus. With 600,000 performed annually, they are the second most common surgery for women behind caesarean sections, according to the National Women’s Health Information Center.

    By contrast, many more women – as many as 45 percent – experience some degree of stress incontinence, which is characterized as involuntary urine loss that occurs when women laugh, cough, sneeze or engage in physical activity like exercising.

    The 30-year study conducted by Swedish researchers was published in the October 27th edition of The Lancet. The observational cohort study of women of corresponding age and geographical location focused on 165, 260 women who underwent hysterectomies and 479, 506 women who did not.

    “Hysterectomy for benign indications, irrespective of surgical technique, increases the risk for subsequent stress-urinary-incontinence surgery,” the study authors concluded.

    The greatest risk – 2.7 – occurred within five years of surgery, while the lowest risk of 2.1 times was found among women who were at least 10 years out of surgery. They also found that the risk was higher for women who had delivered more than one baby vaginally.

    While previous smaller studies have shown an increased risk of urinary incontinence, others complicated these findings by reporting no associated risk. These latest results are important in that they do posit strong evidence of such a link.

    “Any woman contemplating an elective hysterectomy should be told that there may be consequences in the future. The jury has been out, but I think the evidence is clear,” said Dr. Altman.

    However, some experts question these newest findings, especially in light of the conflicting evidence in earlier studies. In an editorial accompanying the study, Dr. Adam Magos pointed out that the numbers could be explained by the fact that women who have already had hysterectomies may be more likely to consider surgery an appropriate method treating incontinence.

    “Perhaps it has nothing to do with hysterectomy, and women who agree to hysterectomy are just different in ways that we do not yet understand,” he wrote.

    Either way, more research is needed and experts urge women to discuss a variety of treatment options besides hysterectomy, and to thoroughly explore the benefits and risks of surgical interventions.

    Last updated: 03-Dec-07

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