Abstract
Purpose
Currently, controversy exists with regard to the duration of bladder drainage and choice of catheter used in women who undergo radical hysterectomy. In this manuscript, we propose a novel approach to improving postoperative bladder care in women who undergo radical hysterectomy.
Methods
This is a retrospective study of women who underwent Type 3 Piver radical hysterectomy in a gynaecological oncology centre in the United Kingdom from January 2009 to September 2011. We report the outcomes of removal of urinary catheter 48–72 h following radical hysterectomy.
Results
Over a 32-month period, 30 women underwent radical hysterectomy. 19 (63.3 %) women underwent surgery for treatment of cervical cancer, 5 (16.7 %) women for management of endometrial cancer, 6 (20 %) women for other conditions. One patient underwent partial cystectomy at the time of radical hysterectomy and was not included in the analysis. Of the 29 patients, only five (17.2 %) were found to have urinary residuals greater than 100 ml following the removal of the indwelling catheter on the second postoperative day and required recatheterisation. 82.8 % of the patients had the catheter removed within 48–72 h postoperatively. None of these patients required re-admission with urinary retention.
Conclusion
Removal of urinary catheter on the second postoperative day following radical hysterectomy is feasible and not associated with increased morbidity. This approach may be particularly useful to complement the introduction of laparoscopic and robotic surgical approaches for surgical management of cervical cancer.
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References
Piver MS, Rutledge F, Smith JP (1974) Five classes of extended hysterectomy for women with cervical cancer. Obstet Gynecol 44:265–272
Zullo MA, Manci N, Angioli R et al (2003) Vesical dysfunctions after radical hysterectomy for cervical cancer: a critical review. Crit Rev Oncol Hematol 48:287–293
Naik R, Nwabinelli J, Mayne C et al (2001) Prevalence and management of (non-fistulous) urinary incontinence in women following radical hysterectomy for early stage cervical cancer. Eur J Gynaecol Oncol 22:26–30
Benedetti-Panici P, Zullo MA, Plotti F et al (2004) Long-term bladder function in patients with locally advanced cervical carcinoma treated with neoadjuvant chemotherapy and type 3–4 radical hysterectomy. Cancer 100:2110–2117
Farquharson DI, Shingleton HM, Orr JW Jr et al (1987) The short-term effect of radical hysterectomy on urethral and bladder function. Br J Obstet Gynaecol 94:351–357
Kadar N, Saliba N, Nelson JH (1983) The frequency, causes and prevention of severe urinary dysfunction after radical hysterectomy. Br J Obstet Gynaecol 90:858–863
Chamberlain DH, Hopkins MP, Roberts JA et al (1991) The effects of early removal of indwelling urinary catheter after radical hysterectomy. Gynecol Oncol 43:98–102
Seski JC, Diokno AC (1977) Bladder dysfunction after radical abdominal hysterectomy. Am J Obstet Gynecol 128(6):643–651
Scotti RJ, Bergman A, Bhatia NN et al (1986) Urodynamic changes in urethrovesical function after radical hysterectomy. Obstet Gynecol 68:111–120
Magrina JF, Pawlina W, Kho RM et al (2011) Robotic nerve-sparing radical hysterectomy: feasibility and technique. Gynecol Oncol 121:605–609
Estape R, Lambrou N, Diaz R et al (2009) A case matched analysis of robotic radical hysterectomy with lymphadenectomy compared with laparoscopy and laparotomy. Gynecol Oncol 113:357–361
Querleu D, Morrow PC (2008) Classification of radical hysterectomy. Lancet Oncol 9:297–303
Wells TH, Steed H, Capstick V et al (2008) Suprapubic or urethral catheter: what is the optimal method of bladder drainage after radical hysterectomy? J Obstet Gynaecol Can 30:1034–1038
Cibula D, Slama J, Velechovska P et al (2010) Factors affecting spontaneous voiding recovery after radical hysterectomy. Int J Gynecol Cancer 20:685–690
Mabrouk M, Frumovitz M, Greer M et al (2009) Trends in laparoscopic and robotic surgery among gynecologic oncologists: a survey update. Gynecol Oncol 112:501–505
Soliman PT, Frumovitz M, Sun CC et al (2011) Radical hysterectomy: a comparison of surgical approaches after adoption of robotic surgery in gynecologic oncology. Gynecol Oncol 123:333–336
Naik R, Jackson KS, Lopes A, Cross P, Henry JA (2010) Laparoscopic assisted radical vaginal hysterectomy versus radical abdominal hysterectomy—a randomised phase II trial: perioperative outcomes and surgicopathological measurements. BJOG 117(6):746–751
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Turnbull, H., Burbos, N., Abu-Freij, M. et al. A novel approach to postoperative bladder care in women after radical hysterectomy. Arch Gynecol Obstet 286, 1007–1010 (2012). https://doi.org/10.1007/s00404-012-2393-4
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DOI: https://doi.org/10.1007/s00404-012-2393-4