Radical hysterectomy has an excellent oncological outcome in cases of cervical or endometrial cancer, but its safety profile is questionable. The Querleu and Morrow classification systemis a surgical classification that describes degree of resection and nerve preservation in three-dimensional (3D) planes of resection. Bladder dysfunction is among the most common complications of radical hysterectomy. Urodynamic studies provide extremely valuable diagnostic data for any of bladder dysfunctions. The most commonly reported changes after radical hysterectomy include urinary incontinence, urinary retention, and voiding by abdominal straining. In addition to voiding dysfunction, impairment of bladder sensationand also alteration of bladder capacity and bladder compliance.Nerve-sparing radical hysterectomy is associated with faster recovery of normal urinary functions compared to conventional approach.
Aim of the Work
To detect any urodynamic changes in female patients before and after radical hysterectomy at El-Shatby Maternity University Hospital.
Subjects and Methods
A total of 42 individuals were recruited in this RCT. Inclusion criteria included patients with cervical cancer (stages IA2 and IIB) or endometrial cancer (any stage) of any age. Patients with stage III or IV cervical cancer were excluded, as well as patients with history of intraoperative bladder injury or patients suffering from any contraindication for urodynamic evaluation. All the study participants were subjected tourodynamic study before undergoing radical hysterectomy, alsoroutine urodynamic evaluation to assess the presence of urinary incontinence, voiding dysfunction, or detrusor hyperactivity was performed at two different time-points: 2 weeks then 3 months post-operatively.