Urinary bladder complications following Wertheim operations--recommendations for a controlled follow-up with comparable conditions (author's transl)

Abstract

At defined times prior and following a Wertheim operation for cancer of the uterine cervix the patients were investigated for the functional parameters of the lower urinary tract. The residual urine was determined. Stress incontinence and urgency incontinence were measured with urethrocystometry. The sensitivity and the micturition were evaluated from subjective data. The results of 237 investigations in 192 operated women are described and compared to previous papers on the subject. Stress incontinence increased to double the pre-operative incidence following the Wertheim operation. An urgency incontinence was quite rare. A lack of feeling of fullness to the bladder as a sign of disturbed bladder sensitivity was present 5 months post-operatively in 6 of 45 patients (13%). This was present in only 1 of 119 patients (1%) after five years. 1/3 of the women had difficulty with spontaneous micturition five months following the operation. 1/10 of the women had difficulty with spontaneous micturition 5 years after the operation. There was no residual urine five months after the operation in 9/10 of the patients and five years following the operation almost 100% of the patients had no residual urine. It was noted that difficulty with spontaneous micturition with residual urine and urgency incontinence did not necessarily result in concomitant bacteriuria. Suggestions are presented how future investigations with similar questions may lead to comparable results.