Does mode of hysterectomy influence micturition and defecation?

Objective. Hysterectomy may affect bladder and bowel function. A retrospect ive study was performed to compare the prevalence of micturition and defeca tion symptoms between different modes of hysterectomy. Methods. All pre-operatively asymptomatic patients, with uteral size less t han or equal to 10 cm, who underwent hysterectomy between 1988 and 1997 wer e interviewed about the prevalence of micturition and defecation symptoms a nd the experienced physical and emotional limitations of these symptoms. Us ing logistic regression analysis, odds ratios (OR) were calculated for all symptoms of which the prevalence between modes of hysterectomy differed mor e than 10%. These odds ratios were adjusted for differences in other progno stic factors. Results. Vaginal hysterectomy was performed on 68 patients, total abdominal hysterectomy on 109 patients and subtotal abdominal hysterectomy on 50 pat ients. An increased prevalence of urge incontinence (adjusted OR 1.5 (95% C I 0.8-3.1)) and feeling of incomplete evacuation (adjusted OR 1.9 (95% CI 1 .0-4.0)) was observed among patients who had undergone vaginal hysterectomy as compared to patients who had undergone total abdominal hysterectomy. Th e prevalence of urge incontinence (adjusted OR 1.8 (95% CI 0.8-4.2)) and di fficulty emptying the rectum (adjusted OR 1.8 (95% CI 0.7-4.4)) was higher among patients who had undergone vaginal hysterectomy than among patients w ho had undergone subtotal abdominal hysterectomy. Statistically significant odds ratios were not observed. Relevant differences in physical and emotio nal limitations related to micturition and defecation symptoms were not obs erved between groups. Conclusion. Our results suggest that technique of hysterectomy may influenc e the prevalence of micturition and defecation symptoms following hysterect omy.