Changes in the function of the lower urinary tract after hysterectomy (original) (raw)
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The short-term prevalence of de novo urinary symptoms after different modes of hysterectomy
The aim of this study was to determine the short-term prevalence of de novo urinary symptoms after hysterectomy indicated by meno/metrorrhagia or dysmenorrhea/dyspareunia. The study group consisted of 451 women who had had a hysterectomy for reasons of meno/metrorrhagia or dysmenorrhea/dyspareunia. Fifty-three (12%) had a supracervical, 151 (33%) a total abdominal and 247 (55%) a vaginal hysterectomy. As a non-gynecologic background population we enrolled 110 women who had had their gallbladder removed laparoscopically. All women received a postal questionnaire 9–45 months after their operation. Specific questions were asked about their voiding habits, comprising significant stress incontinence, bothersome stress incontinence, significant urge incontinence, bothersome urge incontinence, pollakisuria, nocturia, use of pads, and the feeling of having a hygiene problem. To evaluate de novo symptoms or de novo cure, the women assessed the symptoms before as well as after the operation. Results showed that abdominal hysterectomy lasted longer, had heavier blood loss and required longer hospitalization than did vaginal or supracervical hysterectomy. Women scheduled for a supracervical hysterectomy had preoperatively more significant and bothersome urge incontinence, and postoperatively more significant urge, urgency, and feeling of having a hygienic problem than did women having a vaginal hysterectomy, a total abdominal hysterectomy or a laparoscopic cholecystectomy. When assessing de novo symptoms, supracervical hysterectomy was associated with more urgency and the feeling of having a hygienic problem. Some women experienced de novo cure, but these were almost exclusively in the study group and rarely in the control group. It was concluded that supracervical hysterectomy is related to more urinary symptoms than vaginal or total abdominal hysterectomy. De novo symptoms as well as de novo cure are common, which is why urinary symptoms after hysterectomy must be evaluated over time.
Urodynamic evaluation of lower urinary tract function in relation to total abdominal hysterectomy
Pathophysiology, 2005
This study was performed to evaluate lower urinary tract functions in asymptomatic patients by urodynamic measurements after total abdominal hysterectomy and bilateral salpingo-oophorectomy. Twenty asymptomatic patients who had undergone hysterectomy for benign diseases were included in the study and urodynamic measurements were performed before and 6 weeks after total abdominal hysterectomy and bilateral salpingo-oophorectomy. There was no postoperative difference in first urge, normal urge, urgency and maximum bladder capacity but average urethral length, functional urethral length and maximum urethral closing pressure were decreased and also bladder discharging time was increased. Voided volume and residual urine volume were unchanged. It was concluded that total abdominal hysterectomy and bilateral salpingo-oophorectomy did not change the postoperative bladder loading functions in asymptomatic patients but that significant changes occurred in urethral functions.
The frequency, causes and prevention of severe urinary dysfunction after radical hysterectomy
BJOG: An International Journal of Obstetrics and Gynaecology, 1983
Urinary dysfunction that developed in 58 patients treated by radical hysterectomy, with or without total vaginectomy and whole pelvic irradiation over a 10-year period, was studied retrospectively by case record review and telephone enquiry. Seven of the 58 (12%) were found to be severely handicapped, six by incontinence and enuresis, and one by the complete inability to void. Twenty-one (36%) patients had absent bladder sensation or urine loss that caused only minor inconvenience. Advancing age, the menopause, whole pelvic irradiation, and total vaginectomy did not increase the likelihood of developing long-term urinary problems. The determining factor was whether the most lateral portions of the cardinal and uterosacral ligaments had been resected or spared at the time of surgery. It is concluded that serious disability may be avoided by conserving the lateral portions of the pelvic ligaments while obtaining adequate surgical margins during radical hysterectomy.
International Urogynecology Journal, 1991
Lower urinary tract function was evaluated by means of clinical and urodyfiamic assessment in a prospective randomized study including 31 patients undergoing two different types of extended hysterectomy [1] for cervical cancer. In the immediate postoperative period loss of both bladder sensitivity and detrusor voiding activity with reduced compliance was observed in 60% of patients regardless of the operative procedure performed. At 3 months follow-up, the improvement in urethrovesical function was significantly related to a less extensive dissection of pelvic connective tissue (P<0.01).
Indonesian Journal of Obstetrics and Gynecology, 2016
Objective: To assess and compare the incidence of urinary retention in patients post-vaginal and abdominal total hysterectomy for benign gynecological disorders. Method: This is a comparative analytical study with prospective and retrospective cohort design, which was conducted in Dr. Cipto Mangunkusumo Hospital and Persahabatan Hospital from June 2012 to February 2014. Result: We recruited thirty-eight research subjects who underwent abdominal hysterectomy, and 18 subjects who underwent vaginal hysterectomy. The majority of cases underwent the procedure for abnormal uterine myoma (55.5%) and adenomyosis (28.9%). Incidence of urinary retention post-hysterectomy was 33.3% for vaginal hysterectomy, and 31.6% for abdominal hysterectomy. The comparison of the incidence of urinary retention showed no difference between vaginal and abdominal hysterectomies (RR=1.056). Conclusion: Vaginal hysterectomy does not increase the incidence of postoperative urinary retention. However, this study suggests the need for further research with a larger sample size, employing prospective cohort design, with preoperative measurement of postvoiding urine volume (PVR).
International Urogynecology Journal, 2005
The aim of this Danish multicenter trial was to compare the proportion of women with lower urinary tract symptoms after total abdominal hysterectomy (TAH) and subtotal abdominal hysterectomy (SAH) for benign uterine disorders. A total of 319 women were randomized to TAH (n=158) or SAH (n=161). Women were followed up for 1 year by strict data collection procedures, including postal questionnaires. Results were analyzed by intention-to-treat analyses. Urinary incontinence was found less often among TAH women than among SAH women. This was due to a larger reduction of the number of women with stress and urinary incontinence in the TAH group. No other differences were found between the two operation methods. The number of women with urinary incontinence and frequency was reduced from study entry for follow-up, while double/triple voiding was increased. Incontinent women had significantly lower quality of life scores than continent women.
Urodynamic changes following laparoscopic versus vaginal hysterectomy
Archivio Italiano di Urologia e Andrologia
Objective: To compare urodynamic changes before and after hysterectomy (laparoscopic vs. vaginal approach) for benign gynecological diseases.Patients and methods: A total of 90 women with a mean age of 56.36-years were enrolled in this study between August 2019 and April 2021. They were divided into two equal groups(45 patients each). Group, I had a vaginal hysterectomy, and Group II had a laparoscopic hysterectomy. All patients were assessed clinically using ICIQ-FLUTS questionnaire and a uro-dynamic study before and six months after surgery. Results: Both vaginal and laparoscopic hysterectomy did not significantly change the maximum flow rate, voiding time, and average flow rate. The increase in residual urine volume in group I was not significant (p = 0.129), as was in Group II(p = 0.217). All the modifications, however, were within permis-sible limits. According to the cystometry result, volume at initial sensation rose in both groups after surgery, with no statistically significant d...