[Postoperative disorder of bladder emptying in gynecology: pathophysiology and possibilities for treatment]

Abstract

Urinary retention after radical hysterectomy is due to partial or complete denervation of the bladder and proximal urethra which is dependent on surgical radicality. In contrast, incomplete bladder emptying after surgery for stress induced urinary incontinence, has its origin in an infravesicular functional obstruction and is dependent on the operation performed. The use of drugs (alpha-sympatholytics, parasympathomimetics) seem to be of limited value, especially after stress-incontinence surgery. Preoperative information, perioperative supra pubic bladder drainage, postoperative bladder training and in rare cases intermittent self-catheterisation and transurethral surgery are the key factors in successful treatment of postoperative urinary retention.