2018 Volume 61 Issue 3 Pages 156-159
Background Dysfunction of the lower urinary tract is the most commoncomplication of radical hysterectomy (RH). However, there are no establishedtreatment protocols for postoperative underactive bladder (PUB). We developedour own new program for the treatment of underactive bladder (UB) after RH andevaluated it retrospectively.
Methods In this program, there are five steps for patients to followaccording to their urinary condition. The first step is the administration ofurapidil 30 mg, voiding six times at a predetermined time each day, and cleanintermittent catheterization (CIC) after each voiding. As the patient’scondition improves, the number of CICs is reduced, and the medication isstopped. The last step includes voiding six times at a predetermined time eachday. When the volume of residual urine (RU) is less than 100 mL, patients moveon to the next step. When the volume of RU exceeds 100 mL, patients return tothe previous step.
Results Of the 75 patients who visited our department, 41 wereeligible for this program. Twenty-two patients visited our department because ofurinary retention (UR), and 19 patients were admitted because of increased RU.The mean RU volume was 276.3 mL (range, 150–550 mL). After completing theprogram, 39 (95.1%) patients no longer required CIC. The mean time to withdrawalof CIC was 25.1 weeks (range, 1–72 weeks). Thirty-six patients no longerrequired medical treatment, including urapidil, for PUB. Of the 5 patients whohad persistent PUB after treatment, 2 patients continued CIC and urapidil, andthree patients continued urapidil alone.
Conclusion The present results demonstrate that the program of CICin combination with urapidil is effective for the management of PUB afterRH.
