Urodynamic assessment of bladder storage function after radical hysterectomy for cervical cancer.
10.1097/CM9.0000000000001014
- Author:
Ting-Ting CAO
1
;
Hong-Wu WEN
2
;
Yu-Nong GAO
3
;
Qiu-Bo LYU
4
;
Hui-Xin LIU
5
;
Sha WANG
1
;
Shi-Yan WANG
1
;
Hua-Xin SUN
1
;
Na YU
6
;
Hai-Bo WANG
7
;
Yi LI
6
;
Zhi-Qi WANG
1
;
Olivia H CHANG
8
;
Xiu-Li SUN
1
;
Jian-Liu WANG
1
Author Information
1. Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China.
2. Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.
3. Department of Gynecology, Peking University Cancer Hospital & Institute, Beijing 100142, China.
4. Department of Gynecology, Beijing Hospital, Beijing 100005, China.
5. Department of Clinical Epidemiology and Biostatistics, Peking University People's Hospital, Beijing 100044, China.
6. Department of Peking University Medical Information Center, Peking University, Beijing 100191, China.
7. Department of Peking University Clinical Research Institute, Peking University, Beijing 100191, China.
8. Center for Urogynecology and Pelvic Reconstructive Surgery, Cleveland Clinic, Cleveland, OH 44195, USA.
- Publication Type:Journal Article
- From:
Chinese Medical Journal
2020;133(19):2274-2280
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:After radical hysterectomy for cervical cancer, the most common complication is lower urinary tract symptoms. Post-operatively, bladder capacity can alter bladder function for a prolonged period. This study aimed to identify factors affecting bladder storage function.
METHODS:A multicenter, retrospective cohort study was conducted. Information of patients with stages IA2 to IIB cervical cancer with urodynamic study results were retrospectively collected from nine hospitals between June 2013 and June 2018 according to the inclusion criteria. Demographic, surgical, and oncological data were collected. The univariate and multivariate logistic regression was used to identify clinical factors associated with bladder storage function.
RESULTS:Two hundred and three patients with cervical cancer had urodynamic testing post-operatively. Ninety-five (46.8%) patients were diagnosed with stress urinary incontinence (SUI). The incidence of low bladder compliance (LBC) was 23.2%. Twenty-seven (13.3%) patients showed detrusor overactivity (DO). Fifty-seven patients (28.1%) presented with a decreased maximum cystometric capacity (DMCC). The probability of composite bladder storage dysfunction was 68.0%. Multivariate analysis confirmed that laparoscopy represents a protective factor for SUI with an odds ratio of 0.498 (P = 0.034). Patients who underwent a nerve-sparing procedure were less odds to experience SUI (P = 0.014). A significant positive correlation between LBC and DO was observed (P < 0.001). A greater length of the resected vagina and chemoradiotherapy were common risk factors for LBC and DO, while radiotherapy exerted a stronger effect than chemotherapy. Additionally, patients who received chemoradiotherapy frequently developed a DMCC. The follow-up time was not correlated with bladder storage function.
CONCLUSION:A nerve-sparing procedure without longer resected vagina is recommended for protecting the bladder storage function.
