Radical hysterectomy and the function of the lower urinary tract. Urodynamic quantification of changes in storage and evacuation function

Abstract

The intermediate sequelae of radical hysterectomy on the storage and evacuation function of the lower urinary tract were studied by comparison of pre- and postoperative urodynamic parameters. A modified surgical technique was employed in order to remove only the necessary part of the upper part of the vagina and paravaginal tissues. A non-significant reduction in bladder capacity and compliance was found. Urethral function remained unaltered. The most prominent finding was a significant reduction in detrusor contractility and the development of abdominal straining in order to empty the bladder. The pathophysiologic mechanisms by which lower urinary tract is changed after radical hysterectomy are a decrease in the musculo-elastic properties of the bladder wall caused by surgical injury, and partial damage to the neural innervation of the bladder.