Bladder function after radical hysterectomy for cervical cancer.
Neurourol Urodyn
; 34(4): 309-15, 2015 Apr.
Article
en En
| MEDLINE
| ID: mdl-24519734
ABSTRACT
AIM:
To report the effects of radical hysterectomy and nerve-sparing techniques on lower urinary tract function in women.METHODS:
A literature search was performed in Pubmed and Medline using the keywords bladder after radical hysterectomy, nerve sparing radical hysterectomy, and urinary dysfunction following radical hysterectomy. Significant results and citations were reviewed manually by the authors.RESULTS:
The sympathetic and parasympathetic systems innervating the lower urinary tract may be disrupted due to resection of uterosacral and rectovaginal ligaments, the dorsal and lateral paracervix, the caudal part of the vesico-uterine ligaments, and the vagina. This supports the neurogenic etiology of early and late bladder dysfunction after radical surgery. Bladder disorders are also related to the extent of radical surgery. The neuropathopysiology of lower urinary tract symptoms after radical hysterectomy is not fully understood. Recent data have highlighted the role of urethral sphincter pressure in the etiology of postoperative incontinence. Various surgical approaches have been developed to preserve autonomic pelvic innervation.CONCLUSIONS:
Nerve-sparing techniques appear to improve bladder function without compromising overall survival. Studies comparing the effects of nerve-sparing radical hysterectomy with standard surgery yielded encouraging results in respect of postoperative lower urinary tract function. Clinical trials with a long period of follow-up are required for better comprehension of the complex pathophysiology of bladder dysfunction after radical hysterectomy.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Vejiga Urinaria
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Enfermedades de la Vejiga Urinaria
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Neoplasias del Cuello Uterino
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Traumatismos de los Nervios Periféricos
/
Síntomas del Sistema Urinario Inferior
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Histerectomía
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Risk_factors_studies
Límite:
Female
/
Humans
Idioma:
En
Año:
2015
Tipo del documento:
Article