Hysterectomy Is Associated with Stress Incontinence in Women Who Previously Had a Transcervical Endometrial Resection

Objectives: To compare the prevalence of urological symptoms in a population of women, who had a transcervical endometrial resection (TCER) only, and a population of women, who had a TCER and a subsequent hysterectomy. The superior goal was to evaluate the possible association between hysterectomy and urinary incontinence. Design: All women, who had a TCER at our department during the period of 1990–1996 received a questionnaire with focus on urological symptoms. The answers from women, who later had a hysterectomy were compared to the answers from women, who were sufficiently treated with TCER only. Results: Of 356 women, who were alive, 16 were lost to follow-up, leaving 340 women to receive the questionnaire, which was returned by 310 women (85%). Ninety-three (31%) had a subsequent hysterectomy mainly indicated by metrorrhagia or dysmenorrhea. Of the hysterectomized women 24% reported bothersome stress incontinence against 14% in the group of women, who had TCER only (p = 0.03). No significant difference was seen with respect to urge incontinence, urgency, pollakisuria or nocturia. Significantly more women with a normal sized uterus reported bothersome stress incontinence after the hysterectomy compared to women with a slightly enlarged uterus. Conclusion:Hysterectomy is significantly associated with stress urinary incontinence in women, who previously had a TCER.

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