Urodynamic study on postsurgical bladder function in cervical cancer treated with systematic nerve-sparing radical hysterectomy.
The objective of this study was to assess the postsurgical bladder function by urodynamic study in patients with cervical cancer treated with nerve-sparing radical hysterectomy. A total of 27 consecutive patients were included in the study. Of the 27 patients, autonomic nerves had been completely preserved at least on one side in 22 patients (group A), and autonomic nerves could not be successfully preserved in five patients (group B). In group A, there was no significant difference in compliance at the moment of strong desire to void, maximum flow rate, and residual urine volume between before the operation and at 12 months after the operation. However, abdominal pressure at maximum flow had significantly increased in patients of group B than of group A. Detrusor contraction pressure at maximum flow had significantly decreased in patients of group B than of group A. Bladder sensation was diminished in three cases (60%) of group B but preserved in all the patients of group A. Although it is still preliminary, our surgical technique described in this report is thought to be effective for preservation of bladder function. For further evaluation of the efficacy of nerve-sparing radical hysterectomy in terms of quality of life and survival of patients, a prospective randomized trial needs to be performed.
Todo
Y
Y
Department of Gynecology, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-Ku, Sapporo 060-8638, Japan.
Kuwabara
M
M
Watari
H
H
Ebina
Y
Y
Takeda
M
M
Kudo
M
M
Yamamoto
R
R
Sakuragi
N
N
D000328:Adult; D000704:Analysis of Variance; D001341:Autonomic Nervous System / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D011182:Postoperative Care; D011183:Postoperative Complications / Q000175:diagnosis; D011300:Preoperative Care; D011336:Probability; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014555:Urination Disorders / Q000175:diagnosis* / Q000209:etiology; D014563:Urodynamics; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D014599:Uterus / Q000294:innervation*