Urinary incontinence and hysterectomy in a large prospective cohort study in American women
Urinary incontinence and hysterectomy in a large prospective cohort study in American women
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DOI：
10.1016/s0022-5347(05)65091-4
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发表时间：
2002-05-01
影响因子：
6.6
通讯作者：
Harvey, LA
中科院分区：
文献类型：
--
作者：
Kjerulff, KH;Langenberg, PW;Harvey, LA
目的：我们在美国进行的一项关于子宫切除术结局的最大的前瞻性研究中，调查了子宫切除术伴或不伴尿失禁修补术对尿失禁严重程度的影响。材料和方法：我们对1，299名女性在因良性疾病进行子宫切除术前以及术后6、12、18和24个月进行了女性泌尿系统症状量表，尿失禁的严重程度和类型。结果：子宫切除术前，29.5%的参与者患有严重尿失禁，子宫切除术后12个月和24个月，这一比例下降至10%。大多数子宫切除术前严重尿失禁的妇女在术后1年（89.1%）尿失禁改善，2年后仍有改善（86.5%）。大多数子宫切除术前中度尿失禁的妇女在术后1年（62.4%）尿失禁改善，2年后仍有改善（61.2%）。然而，一些子宫切除术前轻度或无尿失禁的妇女在术后1年（16.7%）出现新发尿失禁或病情恶化，2年后仍恶化（14.4%）。伴随的尿失禁修复手术显著增加了严重尿失禁的女性在子宫切除术后1年尿失禁改善的可能性，并显著降低了轻度或无尿失禁的女性在2年后尿失禁恶化的可能性。大多数因非恶性适应症行子宫切除术的妇女在术后的前2年内尿失禁得到改善，手术
Purpose: We investigated the effects of hysterectomy with and without concomitant urinary incontinence repair on incontinence severity in one of the largest prospective studies of hysterectomy outcomes performed in the United States.Materials and Methods: We administered the Urinary Symptoms Scale for Women to 1,299 women before hysterectomy done for benign conditions, and 6, 12, 18 and 24 months postoperatively to measure the presence, severity and type of urinary incontinence.Results: Before hysterectomy 29.5% of participants had severe urinary incontinence, which decreased to 10% 12 and 24 months after hysterectomy. Most women with severe incontinence before hysterectomy showed improved incontinence I year after surgery (89.1%) and were still improved after 2 years (86.5%). The majority of women with moderate incontinence before hysterectomy showed improved incontinence 1 year after surgery (62.4%) and were still improved after 2 years (61.2%). However, some women with mild or no incontinence before hysterectomy had new onset incontinence or the condition had worsened I year after surgery (16.7%) and was still worse after 2 years (14.4%). A concomitant urinary incontinence repair procedure significantly increased the probability that a woman with severe incontinence would have improved incontinence 1 year after hysterectomy and significantly decreased the probability that a woman with mild or no incontinence would have worse incontinence after 2 years.Conclusions: The majority of women who undergo hysterectomy for nonmalignant indications experienced improved urinary incontinence during the first 2 years after surgery.