Archives of Gynecology and Obstetrics

, Volume 291, Issue 4, pp 883–888 | Cite as

Early postoperative bladder training in patients submitted to radical hysterectomy: is it still necessary? A randomized trial

  • Francesco FanfaniEmail author
  • Barbara Costantini
  • Floriana Mascilini
  • Giuseppe Vizzielli
  • Valerio Gallotta
  • Massimo Vigliotta
  • Emilio Piccione
  • Giovanni Scambia
  • Anna Fagotti
Gynecologic Oncology



To evaluate the role of bladder training during postoperative hospital stay in patients submitted to nerve-sparing radical hysterectomy, and to identify any clinical or surgical factor associated with postoperative bladder dysfunction.

Design, setting, and participants

Parallel group randomized single institution trial, on gynaecologic malignancies patients conducted in Catholic University of Sacred Heart Rome, between April 2009 and November 2011. Randomization was on 1:1, using a block randomized computer-generated list.


Patients underwent Querleu-Morrow type B2 or C1 radical hysterectomy. After 2 days from surgery, patients were randomized to perform or not bladder training (scheduled clamping and unclamping of the trans-urethral catheter every three hours). Main outcome measures Necessity and duration of clean intermittent self catheterization.


Randomized participants were 111 women (bladder training arm n = 55; control arm n = 56). A total of 22 women (19.8 %) required clean intermittent self catheterization, equally distributed in the two arms. At univariate analysis, only the type of radical hysterectomy was significantly associated with need of clean intermittent self catheterization (type C1 vs. type B2; p = 0.013). At univariate analysis, duration of clean intermittent self-catheterization was not associated with age, BMI, type of hysterectomy and of neo-adjuvant treatment.


Functional bladder disfunctions are the most common long-term complications following radical hysterectomy. Systematic postoperative bladder training following nerve-sparing radical hysterectomy does not influence the rate of urinary retention or re-admission for bladder catheterization.


Bladder training Radical hysterectomy Gynaecologic cancer Clean intermittent self catheterization 


Conflict of interest

The authors declare no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Francesco Fanfani
    • 1
    Email author
  • Barbara Costantini
    • 1
  • Floriana Mascilini
    • 1
  • Giuseppe Vizzielli
    • 1
  • Valerio Gallotta
    • 1
  • Massimo Vigliotta
    • 1
  • Emilio Piccione
    • 2
  • Giovanni Scambia
    • 1
  • Anna Fagotti
    • 3
  1. 1.Division of Gynecologic OncologyCatholic University of the Sacred HeartRomeItaly
  2. 2.Department of Biomedicine and Prevention, Section of Obstetric and GynecologyTor Vergata, University of RomeRomeItaly
  3. 3.Division of Minimally Invasive Gynecological Surgery, Department of SurgerySt. Maria Hospital, University of PerugiaTerniItaly

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