Objective: The purpose of this study was to evaluate the prevalence of urinary symptoms at long-term follow-up after vaginal hysterectomy. Study design: One hundred and seventeen patients, who had a vaginal hysterectomy for menorrhagia, from January 1991 to December 2001, answered to a self-report questionnaire about de novo urinary symptoms. The control group was a population of 116 patients who had a conservative treatment for dysfunctional uterine bleeding by endometrial thermocoagulation from January 1994 to December 2001. Results: Patient characteristics (mean age, mean parity, menopausal status, smoking status, drink habits) were similar in the two groups. Mean follow-up was 4.6 +/- 2.2 years (range 1.5-11) after vaginal hysterectomy and 4 +/- 1.8 years (range 1.5-7) after conservative treatment. The prevalence of urinary symptoms, included urge and stress incontinence, were statistically similar in the two groups. Conclusion: This study reveals no risk of urge or stress urinary incontinence at long-term follow-up after vaginal hysterectomy, compared with conservative treatment. (c) 2006 Elsevier Ireland Ltd. All rights reserved.