As such, women should be counselled on risks associated with hysterectomy, and other treatment options should be considered before surgery. These are the conclusions of authors of an Article in this week’s edition of The Lancet.
However, an accompanying Comment examines how the Article contradicts previous studies, including by the same authors, and concludes there could be other reasons why the risk increases.
Many women choose hysterectomy because it offers definite cures to, among other conditions, irregular heavy menstrual bleeding, uterine prolapse, and postmenopausal bleeding. Incidence of hysterectomy-related illness post-operation is also low. By age 55, around one five British Women will have undergone hysterectomy.
Dr Daniel Altman, Danderyd University Hospital, Stockholm, Sweden, and colleagues did a 30-year study between 1973 and 2003 of 165260 Swedish women who had undergone hysterectomy (exposed group), and 479506 women who had not (unexposed group), matched by year of birth and area of residence. Occurrence of SUIS in both cohorts was established from the Swedish Inpatient Registry.
The researchers found that the risk of undergoing SUIS was 2.4 times higher in the exposed group compared with the unexposed group, irrespective of surgical technique. They found that the highest overall risk was within five years of hysterectomy, when patients in the exposed group were 2.7 times more likely than those in the unexposed group to require SUIS. The lowest risk was seen in patients more than 10 years after hysterectomy, when the risk was 2.1 times higher for exposed patients.
The authors say: “The most biologically plausible rationale for this association is surgical trauma caused when the uterus and cervix are severed from pelvic-floor supportive tissues at the time of hysterectomy. Hysterectomy could interfere with the intricate urethral sphincter mechanism…it might also result in changes of urethral and bladder neck support.”
“We conclude that hysterectomy, irrespective of surgical technique, increases the risk for stress-urinary-incontinence surgery later in life, with multiparous** women at particular risk. Our findings have important public-health and clinical applications, in view of the many women undergoing hysterectomy for benign indications.”
In the accompanying Comment, Dr Adam Magos, Royal Free Hospital, London, UK, looks at the contradictory results of Altman and colleagues’ findings compared with previous studies. He says: “So, what is the truth? It seems likely that a simple hysterectomy does not adversely affect bladder function, at least initially, and indeed pre-existing symptoms may improve. If hysterectomy-induced urinary stress incontinence is a reality, it only becomes so several years after the surgery, as already suggested. Or perhaps it has nothing to do with hysterectomy, and women who agree to hysterectomy are just different in ways that we do not yet understand.”
Notes to editors: *Benign indications are ones which will not lead to the development of cancer or other life-threatening conditions.
**Multiparous women are women who have given birth to more than one child vaginally, ie. not through caesarean section.
Tony Kirby | alfa
Advanced analysis of brain structure shape may track progression to Alzheimer's disease
26.10.2016 | Massachusetts General Hospital
Indian roadside refuse fires produce toxic rainbow
26.10.2016 | Duke University
Ultrafast lasers have introduced new possibilities in engraving ultrafine structures, and scientists are now also investigating how to use them to etch microstructures into thin glass. There are possible applications in analytics (lab on a chip) and especially in electronics and the consumer sector, where great interest has been shown.
This new method was born of a surprising phenomenon: irradiating glass in a particular way with an ultrafast laser has the effect of making the glass up to a...
Terahertz excitation of selected crystal vibrations leads to an effective magnetic field that drives coherent spin motion
Controlling functional properties by light is one of the grand goals in modern condensed matter physics and materials science. A new study now demonstrates how...
Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.
"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...
In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.
A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...
By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.
"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...
14.10.2016 | Event News
14.10.2016 | Event News
12.10.2016 | Event News
27.10.2016 | Materials Sciences
27.10.2016 | Physics and Astronomy
27.10.2016 | Life Sciences