The Impact of Total Abdominal and Laparoscopically Assisted Vaginal Hysterectomy on the Development of Urine Incontinence

Overview

Objective:
Evaluation of mutual relationship between different types of hysterectomy and urine incontinence.

Design:
Retrospective comparative questionnaire study.

Setting:
Department of Gynaecology and Obstetrics, Charles University and University Hospital Pilsen.

Methods:
Questionnaire study of women which underwent total abdominal hysterectomy (TAH) or laparoscopically assisted vaginal hysterectomy (LAVH) for nonmalignant disease without prolapse between January 2001 and March 2003.

Results:
The questionnare was sent to 286 patients who underwent the operation. 188 (67.6%) were completed and returned. 111 patients were after TAH and 77 after LAVH. 115 patients had no symptoms of incontinence preoperatively. In this group we revealed 20 (17%) patients with SUI a 5 (4%) patients with symptoms of urge incontinence after the operation. In the group of 73 patients with some type of UI preoperatively, 38 women registered improvement and 8 patients were permanently impaired after hysterectomy.

Summary:
After hysterectomy, the continence status is often amended (both either positively or negatively). However, there was no difference between both types of operation. If woman had some type of incontinence preoperatively, this type of incontinence was not worsened after the operation. Contrarywise, these women often registered improvement of their type of incontinence. Age, BMI and number of deliveries were not found statistically significant.

Key words:
intrafascial hysterectomy, total abdominal hysterectomy, laparoscopically assisted vaginal hysterectomy, stress incontinence, urge incontinence, anal incontinence