Incontenance

From
http://www.medscape.com/medscape/features/JournalScan/WomensHealth/2000/js-wh0310.html#J4.1

Hysterectomy and Urinary Incontinence: A Systematic Review
Brown J, Sawaya G, Thom D, Grady D
Lancet. 2000; 356:535-539

Summary
Meta-analysis of 11 observational studies suggests the odds of developing urinary incontinence after hysterectomy is about 40% higher than for women who have not undergone hysterectomy. Researchers performed a meta-analysis to determine whether urinary incontinence is a long-term sequela of hysterectomy.

Twelve studies were included: 8 cross-sectional, 2 prospective cohort studies, 1 case-control, and 1 randomized controlled trial. All the studies presented primary data and compared incontinence in women who underwent hysterectomy with women who did not. Only 2 of the studies relied on urodynamic testing to establish the diagnosis of incontinence; the remainder relied on patient self-reporting.

On the basis of the 11 observational studies, the summary odds ratio for any urinary incontinence in women with hysterectomy compared with those without hysterectomy was 1.4 (95% CI, 1.2-1.7). The summary odds ratio for the 5 studies that included women aged 60 years or older was 1.6 (1.4-1.8).

For 5 studies that included women younger than 60 years, the odds ratio was 1.1 (0.9-1.3). (One study that included only 5 women who had not undergone hysterectomy with urinary incontinence was excluded.) Inclusion of the randomized trial did not substantially alter these results.

The authors did not calculate a summary odds ratio by type of incontinence (stress, urge, or mixed) because of the small number of studies and clinical and statistical heterogeneity of the findings.