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Review
. 2025 Oct 17.
doi: 10.1111/1471-0528.70056. Online ahead of print.

The Impact of Non-Radical Hysterectomy on Urinary Functions: Evaluation of Symptoms-A Systematic Review and Meta-Analysis

Roberta Maria Arseni  1 , Emanuele De Angelis  1 , Ilaria Cuccu  1 , Andrea Giannini  2 , Giorgio Bogani  3 , Francesco Plotti  4 , Corrado Terranova  4 , Roberto Angioli  4 , Tommaso Simoncini  5 , Giuseppe Vizzielli  6 , Stefano Restaino  6 , Jvan Casarin  7 , Massimiliano Fambrini  8 , Flavia Sorbi  8 , Paolo Scollo  9 , Fulvio Zullo  10 , Eliona Demaliaj  11 , Giorgia Perniola  1 , Ludovico Muzii  1 , Violante Di Donato  1
Affiliations
Review

The Impact of Non-Radical Hysterectomy on Urinary Functions: Evaluation of Symptoms-A Systematic Review and Meta-Analysis

Roberta Maria Arseni et al. BJOG. .

Abstract

Background: Simple hysterectomy is one of the most common gynaecological surgical procedures worldwide; however, its association as a possible aetiological factor for urinary dysfunction remains controversial.

Objective: To evaluate the clinical impact of different types of non-radical hysterectomy on lower urinary tract symptoms (LUTS).

Search strategy: A structured search was conducted across scientific sources through December 1989 to March 2025, using terms including: 'urodynamics', 'urinary incontinence', 'stress incontinence', 'urge incontinence', 'urinary urgency', 'urinary frequency', 'urinary nocturia' and 'urinary retention', 'lower urinary tract symptoms', 'hysterectomy'.

Selection criteria: Randomised controlled trials and prospective observational studies assessing patients undergoing simple hysterectomy with pre- and post-operative evaluation by validated questionnaires. Exclusion criteria included case reports, reviews, editorials, short communications, radical hysterectomy, post-operative assessment only, non-English publications and studies on pelvic organ prolapse surgery.

Data collection and analysis: Ten studies, encompassing 1769 patients, were included in the analysis. Five outcomes were selected: changes in urinary frequency; occurrence of stress urinary incontinence; occurrence of urge urinary incontinence; changes in nocturia; changes in incomplete bladder emptying.

Main results: Changes from baseline to last follow-up available in urinary frequency (OR 0.48, 95% CI 0.36-0.66; p < 0.00001); stress urinary incontinence (OR = 0.54, 95% CI 0.44-0.68; p < 0.00001); urge urinary incontinence (OR = 0.76, 95% CI 0.72-0.94; p = 0.01); nocturia (OR 0.55, 95% CI 0.36-0.84; p = 0.005); incomplete bladder (OR = 0.95, 95% CI 0.66-1.36; p = 0.77).

Conclusion: The present meta-analysis suggests that simple hysterectomy is associated with a reduction in the prevalence of urinary symptoms postoperatively.

Trial registration: PROSPERO: CRD42024575574.

Keywords: non‐radical hysterectomy; stress incontinence; urge incontinence; urinary incontinence; urodynamic disfunction; urodynamic tests.

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References

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