Histerectomia por condições ginecológicas benignas e sua relação com as disfunções do assoalho pélvico em mulheres: uma revisão narrativa da literatura

Abstract

Background: Hysterectomy is a treatment option for benign gynecological conditions. Studies of its pelvic floor effects report different results depending on the population, outcome assessed and follow-up duration. Objective: To describe potential pelvic floor repercussions following hysterectomy for benign gynecological conditions, emphasizing urinary changes and pelvic organ prolapse (POP). Methods: A descriptive narrative review of articles published between 2016 and 2026, identified through PubMed/MEDLINE, BVS/LILACS, SciELO and PEDro, with supplementary consultation of the CAPES Portal. Forty-four publications were considered, and 27 original studies were included in the analysis. Results were organized into four domains: urinary outcomes, prolapse, objective function, and anorectal/defecatory outcomes. Results: Observational studies predominated. Long-term registry studies identified associations with subsequent surgery for stress urinary incontinence and POP. Clinical studies also reported improvement, stability or new-onset symptoms. Comparisons between surgical routes showed no consistent superiority. Direct muscle assessments and bowel outcomes were less frequently studied. Conclusion: Results varied according to preoperative status, surgical indication, assessment instrument and follow-up duration. They do not demonstrate uniform functional deterioration or establish that surgery causes the changes. For physiotherapy, the findings support an assessment combining symptoms, daily-life impact and objective measures, alongside prospective studies with better control of factors that may influence the associations.