Study confirms increased risk for stress urinary incontinence surgery after hysterectomy

Women who underwent hysterectomy were more likely to subsequently undergo stress urinary incontinence compared with women who did not have a hysterectomy, confirming previous studies findings.

“As doctors, we need to be aware of this risk every single time we consider performing a hysterectomy,” Karen Ruben Husby, MD, a PhD student at Herlev and Gentofte University Hospital in Herlev, Denmark, told Healio.

Using data from a Danish register, Ruben Husby and colleagues matched women who did (n = 83,370) and did not (n = 413,969) undergo hysterectomy in a 1:5 ratio based on age to evaluate the incidence of surgery for stress urinary incontinence (SUI). All women were born between 1947 and 2000, and those who underwent hysterectomy did not have a tension-free vaginal tape procedure within 2 weeks of hysterectomy.

Overall, women who underwent hysterectomy were more likely to undergo SUI surgery within 30 years of the index date compared with women who did not have a hysterectomy (4.1% vs. 1.5%; HR = 2.7; 95% CI, 2.5-2.9).

The data, which were presented at the American Urogynecologic Society and International Urogynecological Association Scientific Meeting, also indicated an increased risk for SUI surgery with increased parity. Specifically, a history of one vaginal birth was associated with a higher risk for SUI surgery in women who underwent hysterectomy (HR = 15.6; 95% CI, 11-22.1) and those who did not (HR = 5.7; 95% CI, 4-8).

Cesarean deliveries also increased the risk for SUI surgery among both cohorts, the researchers found.

Karen Ruben Husby

“We must consider carefully if a hysterectomy is necessary and if the risk of stress urinary incontinence surgery is outweighed [by the benefits],” Ruben Husby told Healio. “Furthermore, all women should be carefully informed about the risk of stress urinary incontinence.”

Moving forward, Ruben Husby expressed interest in developing prevention methods for SUI.