Bladder function after radical hysterectomy for cervical cancer. Issue 4 (12th February 2014)

• Record Type: Journal Article
• Authors: Laterza, Rosa M.; Sievert, Karl‐Dietrich; de Ridder, Dirk; Vierhout, Mark E.; Haab, Francois; Cardozo, Linda; van Kerrebroeck, Philip; Cruz, Francisco; Kelleher, Con; Chapple, Christopher; Espuña‐Pons, Montserrat; Koelbl, Heinz
• Is Part Of: Neurourology and urodynamics. Volume 34:Issue 4(2015:Apr.)
• Page Start: 309
• Page End: 315
• Publication Date: 2014-02-12
• Subjects: Urinary organs -- Periodicals; Urodynamics -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1002/nau.22570
• Languages: English
• ISSNs: 0733-2467

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>ABSTRACT</title> <sec id="nau22570-sec-0001" sec-type="section"> <title>Aim</title> <p>To report the effects of radical hysterectomy and nerve‐sparing techniques on lower urinary tract function in women.</p> </sec> <sec id="nau22570-sec-0002" sec-type="section"> <title>Methods</title> <p>A literature search was performed in Pubmed and Medline using the keywords <italic>bladder after radical hysterectomy</italic>, <italic>nerve sparing radical hysterectomy</italic>, and <italic>urinary dysfunction following radical hysterectomy</italic>. Significant results and citations were reviewed manually by the authors.</p> </sec> <sec id="nau22570-sec-0003" sec-type="section"> <title>Results</title> <p>The sympathetic and parasympathetic systems innervating the lower urinary tract may be disrupted due to resection of uterosacral and rectovaginal ligaments, the dorsal and lateral paracervix, the caudal part of the vesico‐uterine ligaments, and the vagina. This supports the neurogenic etiology of early and late bladder dysfunction after radical surgery. Bladder disorders are also related to the extent of radical surgery. The neuropathopysiology of lower urinary tract symptoms after radical hysterectomy is not fully understood. Recent data have highlighted the role of urethral sphincter pressure in the etiology of postoperative incontinence. Various surgical approaches have been developed to preserve autonomic pelvic innervation.</p> </sec> <sec id="nau22570-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Nerve‐sparing techniques appear to improve bladder function without compromising overall survival. Studies comparing the effects of nerve‐sparing radical hysterectomy with standard surgery yielded encouraging results in respect of postoperative lower urinary tract function. Clinical trials with a long period of follow‐up are required for better comprehension of the complex pathophysiology of bladder dysfunction after radical hysterectomy. <italic>Neurourol. Urodynam. 34:309–315, 2015</italic>. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>