[Studies on the causes and prophylaxis of urinary tract infection following radical hysterectomy for cervical cancer]

Abstract

In patients undergoing radical hysterectomy for cervical cancer, suprapubic bladder drainage by INGRAM's trocar catheter, which was removed when the postvoiding residual urine was under 30 ml, was attempted to reduce urinary tract infection. The incidence of urinary tract infection was 63.6% during 4 weeks after radical hysterectomy. Most appeared on the 7-14 th postoperative days. In the 6 months after radical hysterectomy, the incidence of significant bacteriuria in the suprapubic group was 9.4% compared to 21.1% in the urethral catheterized group. The difference between the two groups is significant. In view of these results the following is suggested: 1) The antibacterial mechanisms of both the urethra and urinary bladder are greatly weakened immediately following radical surgery for cervical cancer due to organic changes occurring as a result of the surgery. Urethrovesical reflux can regurgitate bacteria from the urethra into the bladder and cause infection despite the absence of urethral catheterization. 2) Indwelling and frequent urethral catheterization for residual urine may cause a chronic urethritis which may prove to be the greatest factor predisposing to urinary tract infection following radical surgery for cervical cancer.