[Urodynamic study on urinary disturbance after therapy of uterine cancer].
It is well known that urinary disturbance often appears after radical hysterectomy for uterine cancer and is aggravated by additional radiation therapy. The aim of this study is to elucidate the pathogenesis and to establish the treatment method of urinary disturbance after therapy for uterine cancer. Forty-five patients with urinary disturbance and ten normal controls were subjected to this study. Changes in clinical symptoms and findings in the Urodynamic study (UDS) in 12 severe cases were investigated before and after treatment with beta 2-stimulant (Mabuterol HCL). Clinical symptoms in cases treated by radiation therapy alone were rare and mild without any pad exchanges, and appeared 5 years after treatment for uterine cancer. Findings of UDS in these cases were mild low compliance of detrusor at maximum desire to void (Cmdv) and mild low bladder volume at maximum desire to void (Vmdv). In cases treated by radical hysterectomy alone, Cmdv decreased immediatelly after the operation and then maximum urethral closure pressure (cPura) gradually decreased. Concerning the cases treated by radical hysterectomy and radiation, severe low Cmdv and severe low Vmdv appeared 5 years after the treatment for uterine cancer in almost all cases, and low cPura appeared immediately after the operation in half of the cases. Treatment with beta 2-stimulant significantly improved urinary frequency, voided volume and urinary incontinence. In UDS findings, Vmdv and Cmdv were significantly improved by the treatment with beta 2-stimulant. The functional profile length and cPura value were not significantly changed. In uroflowmetry, the maximum flow rate and average flow rate were significantly improved by the treatment with beta 2-stimulant.(ABSTRACT TRUNCATED AT 250 WORDS)
Hamada
K
K
Department of Obstetrics and Gynecology, School of Medicine, Ehime University.
Kihana
T
T
Takeda
Y
Y
Inoue
Y
Y
Matsuura
S
S
Kataoka
M
M
Yoshioka
S
S
Iio
S
S
Iwata
H
H
D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002976:Clenbuterol / Q000031:analogs & derivatives / Q000627:therapeutic use; D003187:Compliance; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D008875:Middle Aged; D011878:Radiotherapy / Q000009:adverse effects*; D014521:Urethra / Q000503:physiopathology; D014555:Urination Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D014563:Urodynamics; D014594:Uterine Neoplasms / Q000503:physiopathology / Q000628:therapy*
D000318:Adrenergic beta-Agonists; C044573:mabuterol; D002976:Clenbuterol