Postoperative Urinary Incontinence After Total Abdominal Hysterectomy or Supracervical Hysterectomy: A Meta-Analysis
Bibliographic record
Abstract
Unlike total hysterectomy (TH), supracervical hysterectomy (SCH), also known as subtotal hysterectomy, removes only the body of the uterus, preserving the cervix. In theory, SCH does not damage nerves innervating the bladder and pelvic floor, nor does it disrupt the superior pelvic supports. For these reasons, SCH is thought not to predispose to urinary incontinence. The goal of this meta-analysis was to determine whether the type of hysterectomy performed does, in fact, influence the risk of incontinence. Numerous databases including MEDLINE and the Cochrane Library were searched for abstracts presented at major meetings and bibliographies of retrieved articles. A fixed effect model served to calculate summary relative risk estimates and 95% confidence intervals (CIs). Three studies, all published in the years 2002–2005, were eligible for analysis. All were randomized trials that followed patients for at least 12 months postoperatively. No statistically significant difference in the risk of developing stress urinary incontinence was found between women undergoing SCH and those having total abdominal hysterectomy. The relative risk (RR) was 1.3, with a 95% CI of 0.94–1.78. The RR for urge urinary incontinence was 1.37 (95% CI, 0.77–2.46). Longer follow-up intervals may be needed to accept the conclusion that the extent of hysterectomy does not influence the risk, because observational studies suggest that urinary incontinence may take years to develop following hysterectomy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.016 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.012 | 0.048 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".