A STUDY OF URODYNAMICS

XI-1 Urodynamic Assessment of Neurogenic Bladder after a Radical Hysterectomy

Abstract

The disturbance of micturition resulting from radical hysterectomy for cervical cancer is unavoidable and sometimes has a serious effect upon the prognosis. Though the disturbance varies in degree and in symptom, it should be accurately assessed not only to select an appropriate treatment for itself but also to improve operative methods in the future.
Urodynamic features of the disturbance of micturition were studied precisely in ninety-five patients who had radical hysterectomy. The patients consisted of two groups. One was a thirty-eight patient group of radical hysterectomy with preservation of the pelvic plexus (preserved group). The other was a fifty-seven patient group of the operation with transection of the bilateral pelvic plexus (transected group). Urodynamic examination included exteroceptive sensation of the bladder, CO₂ gas cystometry with electromyography of external anal sphincter, uroflowmetry and urethral pressure profilometry. The examinations were performed prior to the operation and at 1-3, 4-6, 7-12 months, 2-3 years and more than 3 years after the operation.
The results of the urodynamic examinations became stable in four to six months after the operation. The urethral pressure fell and the compliance of the detrusor went down. These were more remarkable in the transected group and seemed to be direct effects of transection of the pelvic plexus. As the volume and the compliance of the bladder seemed to become smaller and lower in the transected group more than three years after the operation, careful observation must be made for years.