The Impact of Hysterectomy on Lower Urinary Tract Symptoms

INTRODUCTION: Hysterectomy is one of the most common procedures still performed in the United States, and “bulk symptoms” are often cited as the indication. Fibroids are known to be associated with lower urinary tract symptoms (LUTS) and hysterectomy could reduce this burden as a definitive treatment when conservative measures have failed. OBJECTIVE: Our objective was to determine the impact of hysterectomy on LUTS in women with symptomatic fibroids, not necessarily presenting to gynecology clinic for said “bulk” symptoms. METHODS: This is a prospective cohort study of patients undergoing hysterectomy for the indication of symptomatic fibroids. Lower Urinary Tract Dysfunction Research Network Symptom Index-10 (LURN-SI-10) is a validated questionnaire that was completed prior to hysterectomy and repeated at 3 months postoperatively to determine symptom burden. Paired t-test compared the difference of LURN-SI-10 scores between baseline and the 3-month post-hysterectomy visit. RESULTS: A total of 41 patients included in this study had a mean ± standard deviation age of 45.6 ± 4.7 years and body mass index of 32.1 ± 5.4 kg/m2. 95% of the patients identified as Hispanic and 31% of the women had multiple fibroids upon presentation. The types of hysterectomies performed were open (51%), laparoscopic (41%), and vaginal (7%). The mean uterine volume on ultrasound was 1,270 ± 1,405 cm3. At baseline, the mean LURN-SI-10 score was 15.0 ± 8.7. At 3 months post-hysterectomy, the mean LURN-SI-10 score was 9.7 ± 5.9. The mean difference between the baseline and the 3-month LURN-SI-10 score was −5.4 ± 8.5 (p=0.0002). CONCLUSIONS: Our 3-month data analysis indicates that definitive treatment with hysterectomy in patients with fibroids appears to decrease LUTS in patients with symptomatic fibroids. We continue to collect data to evaluate the longer-term effects of treatment.