Stress Urinary Incontinence

Stress urinary incontinence after hysterectomy for benign gynecological disease
Introduction:
Urinary incontinence (UI) has been defined by the International Continence Society (ICS) as: “the complaint of any involuntary leakage of urine” or as: “urine leakage seen during examination”. UI is due to the fact that bladder pressure remains lower than urethral closure pressure and incontinence may result from bladder or urethral impairment; when closure pressure is lower than bladder pressure, leakage occurs.4 These type of symptoms lead to a broad range of quality of life impairments from minor discomfort and embarrassment to severe damage to function and quality of life. Lack of ready information, embarrassment and fear of complex treatments

Stress urinary incontinence also has a major effect on health economy and is increasingly recognized as a global health concern. Identification and possible reduction of risk factors for stress urinary incontinence is, therefore, of importance for women at risk and for society’s direct health-care costs.2 Although mortality is rare due to incontinence, it has been shown that it presents as a particularly embarrassing and distressing condition with a significant medical, social and economic implications.

Route of hysterectomy include abdominal, vaginal, laparoscopic or combined approaches. Uterine size, shape of the vagina and uterus, accessibility to the uterus, the need for concurrent procedures, patient characteristics and surgeon training and experience are the main factor to choose the route of hysterectomy. 24 Adnexal surgery and colpoperineoplasty are the most common concomitant procedures related to hysterectomy. 9 It is the most common major gynecological operations performed to treat severe benign gynecological condition in women. It is an effective procedure for curing a number of gynecologic diseases such as uterine fibroids, pelvic organ prolapse, dysfunctional uterine bleeding and malignant condition. It is the second most common major surgery after cesarean section. (i) Forty percent of women all over the world will have hysterectomy by the age of 64 and indication for the majority will be to relieve symptoms and improve quality of life.