Changes in the function of the lower urinary tract after hysterectomy

Abstract

The relationship between the performance of hysterectomy and the function of the lower urinary tract is assessed on the basis of epidemiological and urodynamic studies. Urinary symptoms develop, but also disappear, after hysterectomy. The postoperative prevalence of urinary symptoms is for the major part determined by the preoperative prevalence, which is statistically significantly higher compared to the prevalence of urinary symptoms in the normal population. Apparently, women scheduled for hysterectomy for benign gynecological disease, are somehow different from women not undergoing hysterectomy. However, urodynamic investigations do not show what the difference is. From urodynamic analysis it becomes apparent that hysterectomy causes temporary interruption of bladder function due to surgical injury of the bladder wall. Except for this finding, urodynamic studies show that postoperative lower urinary tract function is essentially determined by preoperative function. Bladder and urethral dysfunction is only likely to develop when the surgical procedure is extended into the paravaginal tissues or when the pelvic plexus is located in the field of normal surgical dissection.