Predicting the development of stress urinary incontinence 3 years after hysterectomy

Abstract

Introduction and hypothesis: We aimed to develop a prediction rule to predict the individual risk to develop stress urinary incontinence (SUI) after hysterectomy.

Methods: Prospective observational study with 3-year follow-up among women who underwent abdominal or vaginal hysterectomy for benign conditions, excluding vaginal prolapse, and who did not report SUI before surgery (n = 183). The presence of SUI was assessed using a validated questionnaire.

Results: Significant prognostic factors for de novo SUI were BMI (OR 1.1 per kg/m(2), 95% CI 1.0-1.2), younger age at time of hysterectomy (OR 0.9 per year, 95% CI 0.8-1.0) and vaginal hysterectomy (OR 2.3, 95% CI 1.0-5.2). Using these variables, we developed the following rule to predict the risk of developing SUI: 32 + BMI-age + (7.5 × route of surgery).

Conclusions: We defined a prediction rule that can be used to counsel patients about their individual risk on developing SUI following hysterectomy.

Fig. 1

Risk score chart, with 95% confidence interval of the prediction rule to estimate the chance of developing SUI 3 years after hysterectomy. Scores are calculated using the developed prediction rule: risk score = 32 + BMI − age + (7.5 × route of surgery)