Voiding disorders after radical hysterectomy

Abstract

The authors report the reaction on bladder function observed in 15 women suffering from cervical cancer in stages I and II after the Wertheim-Meigs radical hysterectomy. All the patients were given various tests before and after operation: urodynamic investigations using uroflowmetry, gas cystometry completed by a urecholine denervation test, cystosphinctermanometry with simultaneous flowmetry, simultaneous recording of bladder and urethral pressures with flowmetry, and urethral closure pressure profile with microtip transducers (Millar Instruments). On the basis of the results, the authors maintain that the damage caused by the operation affects not only the detrusor but also the normal sphincter function as suggested, in fact, by the symptoms observed in the patients (dysuria and stress incontinence). The preoperative urodynamic study was of no help in foreseeing the amount of damage caused by the operation to the normal bladder-sphincter function. On the other hand, the study proved essential postoperatively in clarifying the pathophysiology of the voiding disorders complained of by the patients and, above all, in deciding upon the best plan of management.