Bladder Control Issues and Hysterectomy
Tori Hudson, N.D., Medical Director for Women’s Health Clinic Center, Author Women’s Encyclopedia of Natural Medicine
One of the most common problems I see in my women’s health practice is bladder control issues and occasional urinary incontinence. In fact, nearly 40% of all women will be affected by occasional urinary incontinence at some point in their lives. While there are numerous causes, such as menopause, vaginal delivery, constipation and medications, the relationship of hysterectomy to bladder control issues hasn’t got a lot of attention.
We need a structurally sound bladder, bladder neck, urethra (where the urine exits), surrounding muscles, nerves and supporting tissue, in order to have normal bladder function. Hysterectomy can possibly negatively alter that supporting structure and impact on bladder control.
There are different kinds of hysterectomies that may have different impacts on bladder control. It doesn’t seem to matter if the hysterectomy is done through the vagina (vaginal hysterectomy) or through the abdomen (abdominal hysterectomy). The main concern is what was removed during the surgical procedure.
If the hysterectomy procedure removes the whole uterus, it could also remove some of the structures that are required to provide pelvic support for bladder control. If the hysterectomy removes not only the whole uterus, but also both ovaries, then the procedure will cause not only the structural damage mentioned above, but also cause the dramatic decrease of hormone levels. Both the damage of pelvic supporting structure and lowered hormone levels can contribute to bladder control issues.
Whenever possible, a hysterectomy that spares ovaries and the bottom part of the uterus (called a supra-cervical hysterectomy) is preferred. This type of procedure can avoid the drastic changes in hormone levels to assure a close to normal menopause process, protect the tone of the pelvic floor and maintain bladder control, as well as the integrity and sensation of the vagina.
If you already had occasional urinary incontinence before your hysterectomy, you may experience increasedloss of bladder control issues for the first two years after the hysterectomy. Therefore it becomes even more important for you to discuss with your surgeon about having a supra-cervical hysterectomy as well as keeping your ovaries, if you have a medical condition that warrants a hysterectomy.
As a ND, I always prefer the natural treatment first – “Do no harm” is the guiding principle for naturopathic medicine. When it comes to natural treatments for loss of bladder control with or without hysterectomy, I’ve been using a Chinese herbal formula, Better Woman, for my patients for more than two years now. I have found that most women experience significant improvement in their urinary leakage well within two months. I also recommend Kegel exercises to enhance the tone of the pelvic floor, and sometimes some special pelvic floor rehabilitation techniques with women’s heath physical therapies.
J Urol May 2002; 167:2088-92.
Lancet 2007 Oct 27; 370:1494.
Note: This is the Abstract of the original article, edited to comform to the dietary supplement regulations.