Urinary tract dysfunction after radical hysterectomy for cervical cancer.
OBJECTIVE
To evaluate the urinary tract dysfunction following a radical hysterectomy and to compare the baseline urodynamical parameters of women who had uterine cervical carcinoma with women who had CIN 3.


METHODS
A prospective case-control study was conducted to evaluate preoperative and postoperative urinary tract function of thirty-two cervical carcinoma patients using twenty-seven CIN 3 patients' preoperative urodynamical parameters as a baseline control.


RESULTS
The rate of detrusor instability in women with preoperative cervical carcinoma was higher than that of women with CIN 3 (37.5 % vs. 14.8 %, P < 0.05). In the cervical carcinoma patients, there were 53.1 % who had normal urinary tract function, but after a radical hysterectomy they began voiding by abdominal straining. The impairment of bladder sensation, alteration of bladder capacity and bladder compliance, compromise of detrusor function, reduction of maximal urethral pressure and maximal urethral closure pressure, and the decrease of the pressure transmission ratio were significantly noted after a radical hysterectomy. The rate of genuine stress incontinence did not increase significantly (9.4 % vs. 18.8%, P > 0.05), but the rate of detrusor instability decreased significantly (37.5% vs. 15.6%, P < 0.05) after a radical hysterectomy.


CONCLUSIONS
Changes of urinary tract function after a radical hysterectomy might be related to the partial sympathetic and parasympathetic denervation during a radical dissection. More than half of the women who preoperatively had normal urinary tract function needed to void by abdominal straining after radical surgery.
Chen
Gin-Den
GD
Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, 110, section 2, Chien-Kao N. Road, Taichung 40201, Taiwan. gdchen@hotmail.com
Lin
Long-Yau
LY
Wang
Po-Hui
PH
Lee
Hong-Shen
HS
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000503:physiopathology / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies; D014551:Urinary Tract / Q000503:physiopathology*; D014563:Urodynamics / Q000502:physiology; D014570:Urologic Diseases / Q000209:etiology*; D002583:Uterine Cervical Neoplasms / Q000503:physiopathology / Q000601:surgery*