A comparison of bladder and ovarian function two years following hysterectomy or endometrial ablation

Siladitya Bhattacharya*, Jill Mollison, Sheena Pinion, David E. Parkin, David R. Abramovich, Peter Terry, Henry C. Kitchener

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

66 Citations (Scopus)


Objective To test the hypothesis that at two years bladder and ovarian function function are no different following either simple hysterectomy or endometrial ablation (transcervical resectiodlaser ablation). Design Randomised controlled trial comparing hysterectomy with endometrial ablation. Two years after trial entry bladder and ovarian function were evaluated subjectively by means of questionnaires and objectively by means of cystometry and estimation of serum follicle stimulating hormone respectively. Setting Aberdeen Royal Infirmary. Participants Two hundred and four women with dysfunctional uterine bleeding who, when recruited to the initial study two years previously, were aged less than 50 years, weighed less than 100 kg, and who would otherwise have undergone hysterectomy. Results Of the 204 women originally recruited, 101 re-attended the clinic and underwent cystometry and follicle stimulating hormone estimation. These, together with a further 59 women, completed postal questionnaires (79% of original cohort). Rates of stress incontinence (44%vs 44%, 95% CI of difference −16% to +15%), urge incontinence (21% vs 19% 95% CI of difference −11% to +14%), and hot flushes (30%vs 44%, 95% CI of difference −25% to +7%) were similar in the hysterectomy and endometrial ablation groups, respectively. Cystometry revealed 14 (31%) cases of bladder dysfunction after hysterectomy and 17 (35%) after hysteroscopic surgery (95% CI of difference −23% to +15%). Serum follicle stimulating hormone levels > 40 mIu/L were found in three (6%) women following hysterectomy and five (10%) of women after endometrial ablation. Conclusion This study suggests that in comparison with endometrial ablation, simple hysterectomy for dysfunctional uterine bleeding does not compromise bladder or ovarian function, at least at two years after the operation. Due to lack of power the estimates of any differences are imprecise, and clinically significant effects cannot be ruled out.

Original languageEnglish
Pages (from-to)898-903
Number of pages6
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Issue number9
Publication statusPublished - 1 Jan 1996


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