A systematic review 1 including 8 cross-sectional studies (n=17 925), two prospective cohort studies (n=768), one case-control study (n=140) and one RCT (n=126) was abstracted in DARE. The OR of urinary incontinence in women with hysterectomy compared to those without (11 observational studies) was 1.4 (95% CI 1.2 to 1.7). Heterogeneity was significant (p=0.01). For women aged 60 years of age and over the OR was 1.6 (95% CI 1.4 to 1.8), and for women aged <60 years the OR was 1.1 (95% CI 1.0 to 1.4).
In a Swedish cohort study 2 165 260 women with hysterectomy (exposed cohort) and a control group of 479 506 individuals without hysterectomy (unexposed cohort) were compared. The rate of stress-urinary-incontinence surgery per 100 000 person-years was 179 (95% CI 173 to 186) in the exposed cohort vs. 76 (95% CI 73 to 79) in the unexposed cohort. Correspondingly, the risk for stress-urinary-incontinence surgery was increased in the exposed cohort compared with the unexposed cohort (hazard ratio 2.4; 95% CI 2.3-2.5), irrespective of surgical technique.
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