Cheng Tan, Xin Yang*, Yanjie Wang and Shuqin Qian
Department of Obstetrics and Gynecology, Peking University People's Hospital, ChinaFulltext PDF
Objective: 1) To compare the different effects of adenomyosis (study group) and uterine myoma (control group) on lower urinary tract symptoms (LUTS). 2) To compare the impact of hysterectomy on Lower Urinary Tract Symptoms (LUTS) between patients with uterine adenomyosis and uterine myoma. Who planned to undergo hysterectomy due to menorrhagia or acquired dysmenorrhea during Jan 2012 to Dec 2017 were recruited for this study Bristol Female Lower Urinary Tract Symptoms questionnaire and urinary distress inventory-6 (UDI-6) were conducted to assess the lower urinary tract symptoms of the patients before surgery, and one month and one year after the surgery. Result: 1) The prevalence rate of LUTS before surgery was 51.0% overall, 55.5% in the study group and 47.4% in the control group; The prevalence rate of LUTS 1-year after surgery was 56.5% (59.8% in the study group and 51.8% in the control group) with no significant difference compared with the prevalence rate before surgery. The prevalence rate of urgency in study group (24.5%) is significantly higher than the rate in control group (12.4%). 2) For the study group, the prevalence rate of urinary symptoms such as frequency and urgency was significantly reduced at the 1-month follow up. At1-yearpost operation, the prevalence rate of urinary frequency and urgency was still lower than baseline (frequency: 1-year 21.6% vs. baseline 31.4%; and urgency: 1-year 19.6% vs. baseline 24.5%). 3) The UDI-6 score showed a significant reduction in the total score as well as all breakdown items at the 1-month follow-up; The results of the 1-year-follow-up were comparable with the results before the surgery. 4) The prevalence rate of Stress Incontinence (SUI) was slightly increased in both groups (study group: 1-year 20.6% vs. baseline 16.7%; control group: 1-year 22.6% vs. baseline 19.0%), and the urinary incontinence symptom score in the UDI-6 of both group was increased at the 1-year followup (study group: 1-year 1.79 ± 1.30 vs. baseline 2.09 ± 1.15; control group: 1-year 2.17 ± 0.59 vs. baseline 1.62 ± 1.02). Conclusion: Compared with patients with uterine myoma, patients with uterine adenomyosis are more likely to have LUTS, especially urgency. LUTS of uterine adenomyosis and myoma patients were significantly improved at 1 month after hysterectomy but were not significantly improved after 1 year; additionally, stress incontinence was worsened after 1 year.
Tan C, Yang X, Wang Y, Qian S. Change in Lower Urinary Tract Symptoms after Hysterectomy in Uterine Adenomyosis and Uterine Myoma Patients- A Prospective and Comparative Study with 1-year Followup. Clin Surg. 2019; 4: 2617.