Urinary incontinence more than 15 years after premenopausal risk-reducing salpingo-oophorectomy: a multicentre cross-sectional study

Terra, L.; Heemskerk-Gerritsen, B.A.M.; Beekman, M.J.; Engelhardt, E.; Mourits, M.J.E.; Doorn, H.C. van; ... ; Leeuwen, F.E. van (2023)

Article / Letter to editor

Objective: To study the impact of premenopausal risk-reducing salpingo-oophorectomy (RRSO), compared with postmenopausal RRSO, on urinary incontinence (UI) >= 10 years later.Design: Cross-sectional study, nested in a nationwide cohort.Setting: Multicentre in the Netherlands.Population: 750 women (68% BRCA1/2 pathogenic variant carriers) who underwent either premenopausal RRSO (<= 45 years, n = 496) or postmenopausal RRSO (>= 54 years, n = 254). All participants were >= 55 years at the time of the study.Methods: Urinary incontinence was assessed by the urinary distress inventory-6 (UDI-6); a score >= 33.3 indicated symptomatic UI. The incontinence impact questionnaire short form (IIQ-SF) was used to assess the impact on women's health-related quality of life (HR-QoL). Differences between groups were analysed using regression analyses adjusting for current age and other confounders.Main outcome measures: Differences in UDI-6 scores and IIQ-SF scores between women with a premenopausal and a postmenopausal RRSO.Results: Women in the premenopausal RRSO group had slightly higher UDI-6 scores compared with women in the postmenopausal RRSO group (P = 0.053), and their risk of symptomatic UI was non-significantly increased (odds ratio [OR] 2.1, 95% confidence interval [95% CI] 0.93-4.78). A premenopausal RRSO was associated with a higher risk of stress UI (OR 3.5, 95% CI 1.2-10.0) but not with urge UI. The proportions of women with a significant impact of UI on HR-QoL were similar in the premenopausal and postmenopausal RRSO groups (10.4% and 13.0%, respectively; P = 0.46).Conclusions: More than 15 years after premenopausal RRSO, there were no significant differences in overall symptomatic UI between women with a premenopausal and those with a postmenopausal RRSO.

• BRCA pathogenic variant carriers
• health-related quality of life
• menopause
• premenopausal RRSO
• preventive bilateral salpingo-oophorectomy
• stress incontinence
• urge incontinence

• All authors: Terra, L.; Heemskerk-Gerritsen, B.A.M.; Beekman, M.J.; Engelhardt, E.; Mourits, M.J.E.; Doorn, H.C. van; Hullu, J.A. de; Mom, C.H.; Slangen, B.F.M.; Gaarenstroom, K.N.; Beurden, M. van; Lennep, J.R. van; Dorst, E.B.L. van; Kolk, L.E. van der; Collée, J.M.; Wevers, M.R.; Ausems, M.G.E.M.; Engelen, K. van; Beek, I. van de; Berger, L.P.V.; Asperen, C.J. van; Garcia, E.G.; Maas, A.H.E.M.; Hooning, M.J.; Steensma, A.B.; Leeuwen, F.E. van
• Date: 2023-07-02
• Journal: BJOG: An International Journal of Obstetrics and Gynaecology
• Volume: 131
• Issue: 1
• Pages: 99 - 108
• DOI: doi:10.1111/1471-0528.17591
• Link: https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.17591