[Functional disturbances of the lower urinary tract following radical surgery for cervical cancer (author's transl)].
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Abstract
1972 to 1977 141 patients at the university department of gynecology and obstetrics in Innsbruck had radical abdominal hysterectomies according to Latzko because of carcinoma of the cervix uteri state I-IIa. 111 (78.8%) patients without recurrence of carcinoma were investigated without recurrence of carcinoma were investigated in the period of 2 to 36 months after operation in a modern urodynamic testing unit to state functional troubles of the lower urinary tract. We judged the sensibility of the bladder, the incidence of urinary incontinence, residual urine determinations and the frequency of infections of the lower urinary tract after radical hysterectomies. In particular we were interested in the urodynamic investigation (spontaneous flow rate and uroflow-metrie after bladder filling, liquid cystometry and simultaneous measurement of the pressure in the rectum for a faithful expression of the detrusor pressure). Based on these investigations we could indicate a typical type of troubles after radical abdominal hysterectomies, which partly depends on lesions of the autonomous nerval system of the lower urinary tract. 89.5% of all these patients within the first year after operation could not feel any desire to void although the bladder was full. Longer than one year after operation we could find the same symptom in 45.5%--recovery in part seems to be possible. Moreover we could find unnoticed urinary loss, residual urine and infections of the lower urinary tract (24.7%) in higher incidence compared with a control group. Because of our investigation we could work out advice for prevention and therapy of functional troubles of the lower urinary tract after radical abdominal hysterectomy.
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