The Impact of Non-Radical Hysterectomy on Urinary Functions: Evaluation of Symptoms-A Systematic Review and Meta-Analysis.

BACKGROUND

Simple hysterectomy is one of the most common gynaecological surgical procedures worldwide; however, its association as a possible aetiological factor for urinary dysfunction remains controversial.

OBJECTIVE

To evaluate the clinical impact of different types of non-radical hysterectomy on lower urinary tract symptoms (LUTS).

SEARCH STRATEGY: A structured search was conducted across scientific sources through December 1989 to March 2025, using terms including: 'urodynamics', 'urinary incontinence', 'stress incontinence', 'urge incontinence', 'urinary urgency', 'urinary frequency', 'urinary nocturia' and 'urinary retention', 'lower urinary tract symptoms', 'hysterectomy'.

SELECTION CRITERIA: Randomised controlled trials and prospective observational studies assessing patients undergoing simple hysterectomy with pre- and post-operative evaluation by validated questionnaires. Exclusion criteria included case reports, reviews, editorials, short communications, radical hysterectomy, post-operative assessment only, non-English publications and studies on pelvic organ prolapse surgery.

DATA COLLECTION AND ANALYSIS: Ten studies, encompassing 1769 patients, were included in the analysis. Five outcomes were selected: changes in urinary frequency; occurrence of stress urinary incontinence; occurrence of urge urinary incontinence; changes in nocturia; changes in incomplete bladder emptying.

MAIN

RESULTS

Changes from baseline to last follow-up available in urinary frequency (OR 0.48, 95% CI 0.36-0.66; p < 0.00001); stress urinary incontinence (OR = 0.54, 95% CI 0.44-0.68; p < 0.00001); urge urinary incontinence (OR = 0.76, 95% CI 0.72-0.94; p = 0.01); nocturia (OR 0.55, 95% CI 0.36-0.84; p = 0.005); incomplete bladder (OR = 0.95, 95% CI 0.66-1.36; p = 0.77).

CONCLUSION

The present meta-analysis suggests that simple hysterectomy is associated with a reduction in the prevalence of urinary symptoms postoperatively.

TRIAL REGISTRATION: PROSPERO: CRD42024575574.