Lower urinary tract dysfunction as persistent complication of radical hysterectomy.
BACKGROUND
This study was performed to evaluate late effects on the lower urinary tract after radical hysterectomy.


METHODS
We studied 9 women treated with radical hysterectomy for cervical cancer. All patients underwent surgery more than 10 years age (range, 14 to 36 years). Six patients had urologic complications associated with lower urinary tract dysfunction. The remaining 3 were referred for urinary tract abnormalities detected by radiologic examinations. Lower urinary tract function was evaluated with thorough history taking, laboratory examinations, intravenous urography, and conventional urodynamic studies.


RESULTS
Obstructive voiding symptoms and/or urinary incontinence were observed in 7 patients. Uroflowmetry, which was assessable in 7 patients, revealed intermittent flow and a significant amount of residual urine in all patients. Cystometry revealed impaired bladder sensation, detrusor areflexia, straining on voiding, and probable impaired relaxation of the sphincter in all assessable patients. In addition, decreased bladder compliance was observed in 5 patients.


CONCLUSIONS
All of the examined patients had severe and complicated urinary tract dysfunctions, even at more than 10 years after surgery. Careful follow-up may be mandatory for patients after radical hysterectomy, because compensating factors tend to mask their urologic symptoms.
Sekido
N
N
Department of Urology, University of Tsukuba, Japan.
Kawai
K
K
Akaza
H
H
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D011183:Postoperative Complications; D011312:Pressure; D001750:Urinary Bladder, Neurogenic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D014546:Urinary Catheterization / Q000009:adverse effects; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000209:etiology; D014555:Urination Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D014563:Urodynamics; D014567:Urography
D000900:Anti-Bacterial Agents