Urodynamic evaluation for the changes in bladder and urethral function after nerve-sparing radical hysterectomy

Non-Moderated Poster Session

12:30 PM - 1:30 PM

Tsuyoshi Majima (1), Shun Takai (1), Yasuhito Funahashi (1), Yoshihisa Matsukawa (1), Tokunori Yamamoto (1), Momokazu Gotoh (1)

(1) Nagoya University Graduate School Of Medicine, Nagoya, Japan

We evaluated the changes in bladder and urethral function over time in patients undergoing nerve-sparing radical hysterectomy by conducting a urodynamic study.

AIMS

This was a single-centre, prospective study. Female patients undergoing nerve-sparing radical hysterectomy were enrolled. Urethral pressure profiling (UPP) and pressure flow study (PFS) were performed before and 1 and 6 months after the surgery. The International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) were also evaluated at the time of the urodynamic study.

METHODS

Twenty-five patients were included in the study. The total IPSS significantly increased 1 month after the surgery, and thereafter decreased 6 months after the surgery. The changes in the OABSS showed a similar tendency as well (Table 1). UPP showed that the maximum urethral closure pressure (MUCP) significantly decreased 1 month after the surgery, but remained the same 6 months after the surgery as that 1 month after the surgery. The PFS indicated that first desire to void and maximum cystometric capacity were increased 1 and 6 months after the surgery. Bladder contractility index (BCI) and voiding efficiency were decreased 1 month after, but improved 6 months after the surgery (Table 2). Fourteen of the 25 (56%) patients showed a low BCI (<100) 1 month after and 5 (20%) patients still showed a low BCI even 6 months after the surgery. Pre- to post-operative reduction rate of the BCI significantly correlated with pre- to post-operative reduction rate of MUCP (p = 0.004, r = 0.57).

RESULTS

Our study demonstrated that nerve-sparing radical hysterectomy tended to cause impaired detrusor contractility and urethral function. Thus, patients undergoing this procedure should be counselled before the surgery and carefully followed up after the surgery.

CONCLUSIONS