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Patient-reported lower urinary tract symptoms after hysterectomy or hysteroscopy: a study from the Swedish Quality Register for Gynecological Surgery

Artikel i vetenskaplig tidskrift
Författare Mathias Pålsson
Jan-Henrik Stjerndahl
G. Granasen
M. Lofgren
Karin Sundfeldt
Publicerad i International Urogynecology Journal
Volym 28
Nummer/häfte 9
Sidor 1341-1349
ISSN 0937-3462
Publiceringsår 2017
Publicerad vid Institutionen för kliniska vetenskaper, sektionen för kvinnors och barns hälsa, Avdelningen för obstetrik och gynekologi
Sidor 1341-1349
Språk en
Länkar dx.doi.org/10.1007/s00192-017-3268-...
Ämnesord Hysterectomy, Hysteroscopy, Quality register, Urinary incontinence, Urinary urgency, of-life, endometrial ablation, risk-factors, incontinence, women, outcomes, bladder, finhyst, cohort, trial, Obstetrics & Gynecology, Urology & Nephrology
Ämneskategorier Obstetrik och gynekologi

Sammanfattning

Introduction and hypothesis Hysterectomy is sometimes considered the cause of lower urinary tract symptoms (LUTS). We hypothesized that hysterectomy for abnormal uterine bleeding and/or symptoms of fibroids is more likely to cause LUTS than a hysteroscopic procedure for the same indications. Method Two groups of women were compared: one group comprised 3,618 women who had had a hysterectomy due to abnormal uterine bleeding or symptoms of fibroids and the other group comprised 238 women who had had hysteroscopic treatment for the same indications. The main outcome measures were occurrence of LUTS before and 1 year after the surgical intervention. The frequencies of LUTS before and after surgery were compared between the groups. Binary logistic regression was used to model the odds of having postoperative urinary leakage and urgency while controlling for uterine size, surgical procedure and preoperative LUTS. Result There were no statistically significant differences between women after hysterectomy and after hysteroscopy in the frequencies of LUTS before or after surgery, when uterine size was comparable. However, there was a difference in the rates of de novo urinary incontinence between women with hysterectomy and women with hysteroscopy (7.6%, 95% CI 6.3-9.0, and 3.2%, 95% CI 1.6-6.5, respectively). Of the women with a large uterus, 58.6% (95% CI 51.5-65.5) reported relief of urinary incontinence and 85.5% (95% CI 82.3-88.4) reported relief of urinary urgency postoperatively. Conclusion Our results suggest that it is important to individualize preoperative information in women prior to hysterectomy since the outcome concerning LUTS depends on preoperative symptoms and uterine size.

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