[Show abstract][Hide abstract] ABSTRACT: The aim of the study is to investigate the changes in continence status in a population of women hysterectomized in 1998-2000. Four hundred fifteen hysterectomized women who participated in a questionnaire study on continence status in September 2001 were retested with the same questionnaire on actual continence status in January 2005. As controls we used 97 women who had a laparoscopic cholecystectomy in 1999-2000 and were tested and retested similarly. Urinary incontinence was defined as involuntary urinary leakage at least once a week. Stress incontinence was defined as leakage when coughing, laughing, or lifting heavy weights. Urge incontinence was defined as an uncontrollable desire to void with leakage before reaching the toilet. Stress incontinence was reported by 30% of the hysterectomized women in 2005 vs 28% in 2001. The similar prevalences of urge incontinence were 15 and 13%, respectively. Women who had a subtotal hysterectomy significantly more often had stress incontinence compared to controls in 2005 and 2001. No other significant differences were found. However, the similar prevalences of incontinence reflected that 16% of the hysterectomized women changed from continent in 2001 to stress incontinent in 2005, while 32% changed from stress incontinent to continent. For urge incontinence the similar changes were 8 and 35%, respectively. A large proportion of women change from continent to incontinent or from incontinent to continent during the 3 years of investigation, which should be born in mind when prevalence studies on urinary incontinence are evaluated. Previous hysterectomy does not seem to be of great importance for the development of de novo incontinence or remission.
International Urogynecology Journal 05/2007; 18(4):379-82. · 2.16 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to determine the short-term prevalence of de novo urinary symptoms after hysterectomy indicated by meno/metrorrhagia or dysmenorrhea/dyspareunia. The study group consisted of 451 women who had had a hysterectomy for reasons of meno/metrorrhagia or dysmenorrhea/dyspareunia. Fifty-three (12%) had a supracervical, 151 (33%) a total abdominal and 247 (55%) a vaginal hysterectomy. As a non-gynecologic background population we enrolled 110 women who had had their gallbladder removed laparoscopically. All women received a postal questionnaire 9-45 months after their operation. Specific questions were asked about their voiding habits, comprising significant stress incontinence, bothersome stress incontinence, significant urge incontinence, bothersome urge incontinence, pollakisuria, nocturia, use of pads, and the feeling of having a hygiene problem. To evaluate de novo symptoms or de novo cure, the women assessed the symptoms before as well as after the operation. Results showed that abdominal hysterectomy lasted longer, had heavier blood loss and required longer hospitalization than did vaginal or supracervical hysterectomy. Women scheduled for a supracervical hysterectomy had preoperatively more significant and bothersome urge incontinence, and postoperatively more significant urge, urgency, and feeling of having a hygienic problem than did women having a vaginal hysterectomy, a total abdominal hysterectomy or a laparoscopic cholecystectomy. When assessing de novo symptoms, supracervical hysterectomy was associated with more urgency and the feeling of having a hygienic problem. Some women experienced de novo cure, but these were almost exclusively in the study group and rarely in the control group. It was concluded that supracervical hysterectomy is related to more urinary symptoms than vaginal or total abdominal hysterectomy. De novo symptoms as well as de novo cure are common, which is why urinary symptoms after hysterectomy must be evaluated over time.
[Show abstract][Hide abstract] ABSTRACT: The aim of the study was to investigate the time interval from the operation to no feeling of illness at all in a population of women, who had undergone a total abdominal or vaginal hysterectomy.
Data on 361 women who had had a total abdominal or vaginal hysterectomy during the period, 1.1.1998 to 31.3.1999 were collected from a regional database. Those born before 1.1.1940, presented with a genital malignancy, had a diagnosis of genital prolapse, or received surgery in addition to the hysterectomy were excluded. Four months after the hysterectomy, all the women were sent a questionnaire asking about the time of returning to work and the complete absence of any feeling of illness. This information was related to selected perioperative data. Women who had had a total abdominal hysterectomy were not statistically comparable with those who had had a vaginal hysterectomy.
A total of 313 women participated (87%). After a total abdominal hysterectomy, 92%, 80%, and 35% had a subjective feeling of illness at four, six, and ten weeks, respectively. The median duration of feeling ill was nine weeks. The figures after a vaginal hysterectomy were 85%, 71%, and 18%, with a median duration of feeling ill of seven weeks. Only peroperative blood loss and the presence of postoperative complications related statistically to the duration of feeling ill.
The interval between the operation and no feeling of illness at all after a total abdominal or vaginal hysterectomy is longer than was formerly believed. Further investigation is recommended.