Journal of the American Medical Association
March 2005;293(8):935-948
Hysterectomy Linked
to Later Incontinence
Although serious complications after hysterectomies are estimated to
occur in around 6 women per 10,000 surgeries, it does substantially
increase a woman's risk of having urinary incontinence, but often not
until years after she has her uterus removed.
Researchers found 45 previous studies which looked at this association,
and then narrowed these down to 12 studies which met very rigid
selection criteria. From these studies, they determined that:
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Among women age 60 and older, those who had a
hysterectomy were 60% more likely to become incontinent than those
who did not have the surgery.
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Overall, women who had a hysterectomy were about 40%
more likely to develop incontinence.
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Dr. Jeanette S. Brown, of the University of
California, San Francisco, and her colleagues recommend that women
who are considering a hysterectomy should be made aware of the
potential risk for incontinence.
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She notes that about 90% of the time a hysterectomy
is used to treat non-cancerous health problems like vaginal bleeding
and benign growths in the uterus.
"Women need to decide how much their uterine symptoms are affecting
their quality of life today," Dr. Brown stated. "Women should weigh what
the immediate benefits are of a hysterectomy versus the long-term risks
later in life."
Hysterectomy is the second most common type of major surgery, being
performed on more than 600,000 women in the US each year.
About 40% of all women in the US will have a hysterectomy by age 60.
For unknown reasons, the increased risk of incontinence appears to
strike women years, or even decades, after having a hysterectomy. The
researchers note that this may occur because hysterectomies may cause
damage to nerves and other parts of the pelvis that may take a while to
cause incontinence.
The Lancet
2000;356:535-539.
Urinary incontinence
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loss
of bladder control
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