Removal of uterus increases risk of urinary incontinence

Researchers at the Swedish medical university Karolinska Institutet have shown that hysterectomy – a common operation involving the removal of the uterus – greatly increases the risk of urinary incontinence.

Their results, which come from a nationwide study, are presented in The Lancet.

Hysterectomy is the most common gynaecological abdominal operation in the world. It is normally performed as a cure for benign medical problems in order to improve life quality for the patients. However, the long-term effects are largely unknown, and it has long been suspected that the operation increases the risk of developing urinary incontinence, in many respects a very disabling condition that affects hundreds of thousands of women in Sweden.

Researchers at Karolinska Institutet have now shown that women who have had a hysterectomy are more than twice as likely to undergo surgery for urinary incontinence as women with intact uteri.

“It’s important that gynaecologists take this into account ahead of a hysterectomy, and the patients should themselves be aware of the greater risk the operation entails, particularly if they belong to a high-risk group,” says Daniel Altman, gynaecologist and one of the researchers behind the study.

The highest likelihood of incontinence surgery was noted within five years of the removal of the uterus, but the higher risk remains throughout the patients’ lives. The risk increased most for women who had a hysterectomy before their menopause or after having undergone several deliveries.

The study was based on analyses of patient registers for the years 1973 to 2003, and incorporated over 165,000 women who have had hysterectomies and almost 479,000 women who have not.