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Bladder function after radical hysterectomy for cervical cancer
Author(s) -
Laterza Rosa M.,
Sievert KarlDietrich,
de Ridder Dirk,
Vierhout Mark E.,
Haab Francois,
Cardozo Linda,
van Kerrebroeck Philip,
Cruz Francisco,
Kelleher Con,
Chapple Christopher,
EspuñaPons Montserrat,
Koelbl Heinz
Publication year - 2015
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.22570
Subject(s) - medicine , radical hysterectomy , hysterectomy , urinary system , etiology , surgery , vagina , urinary incontinence , urology , cervical cancer , cancer
Aim To report the effects of radical hysterectomy and nerve‐sparing techniques on lower urinary tract function in women. Methods A literature search was performed in Pubmed and Medline using the keywords bladder after radical hysterectomy , nerve sparing radical hysterectomy , and urinary dysfunction following radical hysterectomy . Significant results and citations were reviewed manually by the authors. Results 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. Conclusions 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. Neurourol. Urodynam. 34:309–315, 2015 . © 2014 Wiley Periodicals, Inc.