{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:45:26Z","timestamp":1790747126570,"version":"4.1.0"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T00:00:00Z","timestamp":1642723200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T00:00:00Z","timestamp":1642723200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Helsinki including Helsinki University Central Hospital"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Gynecol Obstet"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Hysterectomy has been associated with increased risk for developing stress urinary incontinence (SUI) and having a SUI operation. We examined the long-term rate of SUI operations after hysterectomy and associated risk factors.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We followed up 5000 women without prior urinary incontinence (UI) who had a hysterectomy in a prospective FINHYST 2006 cohort study until the end of 2016 through a national health register. The main outcome was SUI operations, and secondary outcomes were outpatient visits for UI, and their association of preoperative patient and operation factors.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>During the median follow-up time of 10.6\u00a0years (IQR 10.3\u201310.8), 111 (2.2%) women had a SUI operation and 241 (4.8%) had an outpatient visit for UI. The SUI operation rate was higher after vaginal hysterectomy and laparoscopic hysterectomy (<jats:italic>n<\/jats:italic>\u2009=\u200971 and 28, 3.3% and 1.8%, respectively) compared to abdominal hysterectomy (<jats:italic>n<\/jats:italic>\u2009=\u200911, 0.8%). In a multivariate risk analysis by Cox regression, the association with vaginal hysterectomy and SUI operation remained significant when adjusted for vaginal deliveries, preceding pelvic organ prolapse (POP), uterus size, age and BMI (HR 2.4, 95% CI 1.1\u20135.3). Preceding POP, three or more deliveries and laparoscopic hysterectomy were significantly associated with UI visits but not with SUI operations.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>After hysterectomy, 2.2% of women underwent operative treatment for SUI. The number of SUI operations was more than double after vaginal hysterectomy compared to abdominal hysterectomy, but preceding POP explained this added risk partially. Preceding POP and three or more vaginal deliveries were independently associated with UI visits after hysterectomy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00404-021-06378-z","type":"journal-article","created":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T14:02:45Z","timestamp":1642773765000},"page":"1089-1097","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Stress urinary incontinence after hysterectomy: a 10-year national follow-up study"],"prefix":"10.1007","volume":"305","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2039-8242","authenticated-orcid":false,"given":"Sari","family":"Tulokas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Mentula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"H\u00e4rkki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Brummer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Jalkanen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Kuittinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"M\u00e4kinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Sj\u00f6berg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Tomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Rahkola-Soisalo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,1,21]]},"reference":[{"issue":"2 Pt 1","key":"6378_CR1","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1097\/AOG.0b013e318299a6cf","volume":"122","author":"JD Wright","year":"2013","unstructured":"Wright JD, Herzog TJ, Tsui J, Ananth CV, Lewin SN, Lu YS et al (2013) Nationwide trends in the performance of inpatient hysterectomy in the United States. Obstet Gynecol 122(2 Pt 1):233\u2013241","journal-title":"Obstet Gynecol"},{"issue":"10","key":"6378_CR2","doi-asserted-by":"publisher","first-page":"2515","DOI":"10.1093\/humrep\/dep229","volume":"24","author":"TH Brummer","year":"2009","unstructured":"Brummer TH, Jalkanen J, Fraser J, Heikkinen AM, Kauko M, Makinen J et al (2009) FINHYST 2006-national prospective 1-year survey of 5279 hysterectomies. Hum Reprod 24(10):2515\u20132522","journal-title":"Hum Reprod"},{"key":"6378_CR3","first-page":"CD003677","volume":"8","author":"JW Aarts","year":"2015","unstructured":"Aarts JW, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BW et al (2015) Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 8:CD003677","journal-title":"Cochrane Database Syst Rev"},{"issue":"9597","key":"6378_CR4","doi-asserted-by":"publisher","first-page":"1494","DOI":"10.1016\/S0140-6736(07)61635-3","volume":"370","author":"D Altman","year":"2007","unstructured":"Altman D, Granath F, Cnattingius S, Falconer C (2007) Hysterectomy and risk of stress-urinary-incontinence surgery: nationwide cohort study. Lancet 370(9597):1494\u20131499","journal-title":"Lancet"},{"issue":"1","key":"6378_CR5","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/S0090-4295(02)02243-4","volume":"61","author":"P Abrams","year":"2003","unstructured":"Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U et al (2003) The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology 61(1):37\u201349","journal-title":"Urology"},{"issue":"2","key":"6378_CR6","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.ajog.2005.07.051","volume":"194","author":"KN Danforth","year":"2006","unstructured":"Danforth KN, Townsend MK, Lifford K, Curhan GC, Resnick NM, Grodstein F (2006) Risk factors for urinary incontinence among middle-aged women. Am J Obstet Gynecol 194(2):339\u2013345","journal-title":"Am J Obstet Gynecol"},{"issue":"6","key":"6378_CR7","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1177\/1403494812456637","volume":"40","author":"R Sund","year":"2012","unstructured":"Sund R (2012) Quality of the Finnish Hospital Discharge Register: a systematic review. Scand J Public Health 40(6):505\u2013515","journal-title":"Scand J Public Health"},{"issue":"7","key":"6378_CR8","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1007\/s00192-015-2926-z","volume":"27","author":"K Kurkijarvi","year":"2016","unstructured":"Kurkijarvi K, Aaltonen R, Gissler M, Makinen J (2016) Surgery for stress urinary incontinence in Finland 1987\u20132009. Int Urogynecol J 27(7):1021\u20131027","journal-title":"Int Urogynecol J"},{"issue":"1","key":"6378_CR9","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1007\/s00192-011-1523-z","volume":"23","author":"C Forsgren","year":"2012","unstructured":"Forsgren C, Lundholm C, Johansson AL, Cnattingius S, Zetterstrom J, Altman D (2012) Vaginal hysterectomy and risk of pelvic organ prolapse and stress urinary incontinence surgery. Int Urogynecol J 23(1):43\u201348","journal-title":"Int Urogynecol J"},{"issue":"5","key":"6378_CR10","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1016\/j.jmig.2014.04.001","volume":"21","author":"AAGL Advancing Minimally Invasive Gynecology Worldwide","year":"2014","unstructured":"AAGL Advancing Minimally Invasive Gynecology Worldwide (2014) AAGL practice report: practice guidelines on the prevention of apical prolapse at the time of benign hysterectomy. J Minim Invasive Gynecol 21(5):715\u2013722","journal-title":"J Minim Invasive Gynecol"},{"issue":"1","key":"6378_CR11","doi-asserted-by":"publisher","first-page":"53.e1","DOI":"10.1016\/j.ajog.2016.08.034","volume":"216","author":"KS Bohlin","year":"2017","unstructured":"Bohlin KS, Ankardal M, Lindkvist H, Milsom I (2017) Factors influencing the incidence and remission of urinary incontinence after hysterectomy. Am J Obstet Gynecol 216(1):53.e1-53.e9","journal-title":"Am J Obstet Gynecol"},{"issue":"5","key":"6378_CR12","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1111\/1471-0528.12509","volume":"121","author":"JM van der Ploeg","year":"2014","unstructured":"van der Ploeg JM, van der Steen A, Oude Rengerink K, van der Vaart CH, Roovers JP (2014) Prolapse surgery with or without stress incontinence surgery for pelvic organ prolapse: a systematic review and meta-analysis of randomised trials. BJOG 121(5):537\u2013547","journal-title":"BJOG"}],"container-title":["Archives of Gynecology and Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-021-06378-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00404-021-06378-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-021-06378-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T08:08:23Z","timestamp":1648627703000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00404-021-06378-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,21]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["6378"],"URL":"https:\/\/doi.org\/10.1007\/s00404-021-06378-z","relation":{},"ISSN":["1432-0711"],"issn-type":[{"value":"1432-0711","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,21]]},"assertion":[{"value":"29 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 December 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 January 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All the authors declare that they have no conflict of interest or competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study protocol was approved by the Ethical Committee of the Helsinki and Uusimaa Hospital District (Dnro 457\/E8\/04 and 343\/13\/03\/03\/2015) and was registered in the Clinical Trials (NCT00744172). The Finnish Institute for Health and Welfare of Finland authorized the use of the data from the Care Register (THL\/986\/5.05.00\/2018).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}]}}