Women with hysterectomies more likely to have later surgery for incontinence

Women who undergo hysterectomy are much more likely to require subsequent surgery for stress urinary incontinence (SUI), researchers report in the Oct. 27 issue of The Lancet.

Daniel Altman, MD, of the Karolinska Institute in Stockholm, Sweden, and colleagues used the Swedish Inpatient Registry to identify 165,260 women who had undergone hysterectomy between 1973 and 2003. These were matched with 479,506 controls who had not had a hysterectomy. The same registry was used to identify women from both groups who subsequently underwent surgery for SUI.

Women who had received a hysterectomy were more than twice as likely to undergo subsequent surgery for SUI, regardless of the surgical technique used to perform the hysterectomy. The risk of incontinence surgery was highest within the first 5 years after the hysterectomy. A subset analysis showed that women who had given birth vaginally to more than four children before receiving a hysterectomy had substantially greater risk of subsequent SUI.

Altman D, Granath F, Cnattingius S, et al. Hysterectomy and risk of stress-urinary-incontinence surgery: nationwide cohort study. Lancet. 2007;370:1494-1499.