Urodynamic analyses of bladder function after radical abdominal hysterectomy

Lee, Sang Don; Lee, Jeong Zoo; Yoon, Man Soo

Abstract

Bladder dysfunction is a common occurrence following radical abdominal hysterectomy(RAH). Prospective study was underwent to determine the bladder function in 23 patients before and after RAH. The average duration or indwelling catheter was 18.9 days. The average bladder capacity preoperatively, 2-3 weeks and 6-8 weeks postoperatively was 451.7 +/-58.6ml, 338.3 +/-58.2ml and 435.2 +/-92.2ml( p <0.05). The mean filling pressure preoperatively, 2-3 weeks and 6-8 weeks postoperatively was 9.0 +/-.3cmH20, 17.5 +/-1.9cmH2O and 10.2 +/-1.9cmH2O(p <0.05). The average residual urine preoperatively. 2-3 weeks and 6-8 weeks postoperatively was 5.8 +/-4.1ml, 171.8 +/-174.4ml and 22.2 +/-59.2ml(p <0.05 ). Voiding symptoms following RAH were seen 7 patients(30.4 %) : sensory loss in 3, difficulty in initiation in 2, incontinence and strain to empty the bladder in one each. Clean intermittent catheterization(CIC) was performed in 3 patients( 13.0%) with the volume or residual urine more than 100ml due to hypotonic bladder. The hypertonic bladder we seen immediately postoperatively and progressively recovered to preoperative bladder function at 2 weeks, then resolved usually within 6-8 Weeks. We suggest that patients who are unable to self- void or have more than 100ml of residual urine should be examined periodically with urodynamic studies and must be managed actively including CIC or prolonged catheter drainage, which are very good methods to achieve early recovery of bladder function and prevent hypotonic bladder dysfunction.