Urodynamic analysis of recent bladder function following radical hysterectomy / 肿瘤

ABSTRACT

Objective:To study the variation of recent bladder function of the patients who received radical hysterectomy and evaluate its significance. Methods:Sixty-three patients with cervical carcinoma in International Federation of Gynecology and Obstetrics(FIGO) stage IB1 to ⅡA received urodynamic examination before and after operation. The urodynamic parameters included filling cystometry, pressure-flow rate, and electromyography of sphinctienter. Results:Radical hysterectomy induced significant increase in the first sensation (P<0.01)and post voiding residual of bladder (P<0.01) ;whereas caused significant decrease in the maximum volume(P<0.01), compliance(P<0.01),maximum flow rate(P<0.01) and the pressure at the maximum flow rate(P<0.01), respectively, compared with the corresponding values before the operation. Short-term bladder dysfunctions were observed in 34 patients (54.0%) including bladder detrusor dysfunction, low compliance bladder, bladder outlet obstruction, dyssynergia of urethral external sphincter and detrusor overactivity. The incidences of low compliance bladder and bladder detrusor dysfunction increased significantly after operation (P<0.01). Urinary retention was found in 28.6%(18/63) patients. The incidences of bladder detrusor dysfunction (66.7% vs 20.0%) and detrusor overactivity (33.3% vs 4.4%) in the group with urinary retention were significantly higher than those of corresponding group without urinary retention. Conclusion:The bladder function had obvious short-term changes following radical hysterectomy. In the many types of bladder dysfunction the main dysfunctions were low compliance bladder and bladder detrusor dysfunction. The bladder detrusor dysfunction might be the major cause of the urinary retention following the surgery. Urodynamic test was important for post-operative analysis and treatment of bladder dysfunction.