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Hysterectomy and urinary incontinence in postmenopausal women

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Abstract

Introduction and hypothesis

To evaluate an association between hysterectomy and urinary incontinence (UI) in postmenopausal women.

Methods

Women (aged 50–79) with uteri (N = 53,569) and without uteri (N = 38,524) who enrolled in the Women’s Health Initiative (WHI) Observational Study between 1993 and 1996 were included in this secondary analysis. Baseline (BL) and 3-year demographic, health/physical forms and personal habit questionnaires were used. Statistical analyses included univariate and logistic regression methods.

Results

The baseline UI rate was 66.5 %, with 27.3 % of participants having stress urinary incontinence (SUI), 23 % having urge UI (UUI), and 12.4 % having mixed UI (MUI). 41.8 % of women had undergone hysterectomy, with 88.1 % having had the procedure before age 54. Controlling for health/physical variables, hysterectomy was associated with UI at BL (OR 1.25, 95 % CI 1.19, 1.32) and over the 3-year study period (OR 1.23, 95 % CI 1.11, 1.36). Excluding women with UI at BL, a higher incidence of UUI and SUI episodes was found in hysterectomy at year 3. Among women who had undergone hysterectomy, those with bilateral oophorectomy (BSO) did not have increased odds of developing UI at BL or over the 3-year study period. Hormone use was not associated with a change in UI incidence (estrogen + progesterone, p = 0.17; unopposed estrogen, p = 0.41).

Conclusions

Risk of UI is increased in postmenopausal women who had undergone hysterectomy compared with women with uteri.

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Acknowledgements

We gratefully acknowledge the dedicated efforts of investigators and staff at the WHI clinical centers, the WHI clinical coordinating center, and the National Heart, Lung, and Blood Institute program office. Most importantly, we want to recognize the WHI participants for their extraordinary commitment to the WHI program.

Source of the study/funding/support

Study data were obtained from the observational study (OS) of the Women’s Health Initiative (WHI). The WHI program was funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health, Department of Health and Human Services.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Division of Urogynecology, Obstetrics and Gynecology, Winnie Palmer Hospital, Orlando, FL, USA

    Bela I. Kudish

  2. Obstetrics and Gynecology, Hadassah, Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel

    David Shveiky

  3. Obstetrics and Gynecology and Urology, Washington Hospital Center/Georgetown University, Washington, DC, USA

    Robert E. Gutman, Andrew I. Sokol & Cheryl B. Iglesia

  4. Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA, USA

    Vanessa Jacoby

  5. Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Rebecca Rodabough

  6. MedStar, Bethesda, MD, USA

    Barabara V. Howard

  7. John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA

    Patricia Blanchette

  8. 2014 Water Key Drive, Windermere, FL, 34786, USA

    Bela I. Kudish

Authors
  1. Bela I. Kudish
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  2. David Shveiky
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  3. Robert E. Gutman
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  4. Vanessa Jacoby
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  5. Andrew I. Sokol
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  6. Rebecca Rodabough
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  7. Barabara V. Howard
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  8. Patricia Blanchette
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  9. Cheryl B. Iglesia
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Corresponding author

Correspondence to Bela I. Kudish.

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Kudish, B.I., Shveiky, D., Gutman, R.E. et al. Hysterectomy and urinary incontinence in postmenopausal women. Int Urogynecol J 25, 1523–1531 (2014). https://doi.org/10.1007/s00192-014-2422-x

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  • DOI: https://doi.org/10.1007/s00192-014-2422-x

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