Urodynamic and ultrasound characteristics of incontinence after radical hysterectomy.
OBJECTIVE
To test whether symptoms of urinary incontinence after radical hysterectomy could be objectified with urodynamics and ultrasound.


METHODS
This case-control study comprised 100 women who underwent radical hysterectomy for cervical cancer without post-operative radiotherapy. Fifty women reporting urinary incontinence were matched with 50 women reporting continence. All women were assessed with ultrasound of the bladder neck movements and urodynamics.


RESULTS
No differences were found in ultrasound or urodynamic findings regarding mobility of the bladder neck, maximal detrusor pressure, post-voiding residual urine, flow of urine, or bladder capacity. A significant reduction in urethral pressure at rest and at contraction among the incontinent women was, however, demonstrated. Among urge-incontinent women, urethral pressure at rest was significantly lower than among continent and stress-incontinent women, respectively. Stress-incontinent women had significantly lower urethral pressure at contraction than did urge-incontinent and continent women.


CONCLUSIONS
No differences in urodynamic or ultrasound findings were observed between the two groups, except for an overall difference in the intraurethral pressure. A decrease in the urethral pressure could contribute to the characterization of incontinence after radical hysterectomy, indicating that the urethral sphincter mechanism plays a role in the pathophysiology. In this study design, the mobility of the bladder neck did not play any role.
Axelsen
Susanne Maigaard
SM
Department of Gynecology and Obstetrics, Aarhus University Hospital, Skejby Hospital, Aarhus, Denmark. susanne.axelsen@dadlnet.dk
Bek
Karl Moeller
KM
Petersen
Lone Kjeld
LK
D000328:Adult; D000368:Aged; D001284:Atrophy; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D011247:Pregnancy; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging* / Q000503:physiopathology; D053201:Urinary Bladder, Overactive / Q000503:physiopathology; D014549:Urinary Incontinence / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D014563:Urodynamics / Q000502:physiology*; D014596:Uterine Prolapse / Q000503:physiopathology