Risk of overactive bladder after hysterectomy for uterine fibroids.

Yuk, Jin-Sung; Lee, Jun Ho

Introduction and hypothesis: We evaluated the association between previous hysterectomy for uterine fibroids and the risk of developing overactive bladder (OAB). Methods: We used national health insurance data. The hysterectomy group (aged 40 to 59) comprised patients who underwent hysterectomy for uterine leiomyoma or adenomyosis between 1 January 2011 and 31 December 2014, and the control group (aged 40 to 59) comprised patients who visited a medical facility for a checkup during the same time period. Propensity score matching (PSM, 1:1) was performed to balance confounders. OAB events were defined by drug prescriptions (beta 3 agonist or anticholinergics) for more than 1 month based on previous studies. Results: After matching, 58,195 cases (hysterectomy group) and 58,195 controls (nonhysterectomy group) were enrolled. The mean follow-up period was 7.9 years in the nonhysterectomy group and 8.0 years in the hysterectomy group. There was no significant difference in the rate of OAB development between the groups (0.3% vs 0.3%; p=0.061). Additionally, compared with the nonhysterectomy group (hazard ratio: 1 (reference)), hysterectomy without adnexal surgery (hazard ratio: 1.169 [0.915–1.493]) and hysterectomy with adnexal surgery (hazard ratio: 1.342 [0.83–2.171]) did not significantly increase the risk of OAB after adjusting for confounders; this relationship remained nonsignificant after stratifying patients according to age group. Conclusions: Previous hysterectomy with or without adnexal surgery for the treatment of uterine fibroids did not increase the risk of developing OAB, defined as drug therapy lasting more than 1 month.

UTERINE fibroids; OVERACTIVE bladder; HYSTERECTOMY; ENDOMETRIOSIS; NATIONAL health insurance; UTERINE artery; UTERINE myomectomy

International Urogynecology Journal, 2023, Vol 34, Issue 8, p1823

0937-3462

Academic Journal

10.1007/s00192-023-05474-9