International Urogynecology Journal

, Volume 3, Issue 4, pp 292–297 | Cite as

Vaginal cuff size in Wertheim-Meigs radical hysterectomy should be minimized in order to prevent urological complications

  • A. B. F. Crane-Elders
  • F. M. Kauer
  • J. Bouma
  • J. Janssens
Original Article


The possible pathogenesis of urological complications after radical hysterectomy was studied, as well as the influence of cesium irradiation prior to hysterectomy. Thirty-two patients were subjected to a full urodynamic examination, including a detailed medical history, cystometry, urethral pressure profiles, uroflowmetry and a carbachol test, all performed prior to and 6 months following therapy for cervical cancer stage Ib or IIa. No specific influence of cesium irradiation prior to surgery could be found. The only determining factor regarding urologic complications after operation was the length of the vaginal cuff excised. With a small cuff excised no urologic problems were seen; with a cuff of more than 3 cm, however, it was found that there was a substantial risk of dysfunction of the lower urinary tract 6 months after therapy. This finding, as well as an abnormal carbachol test, suggests denervation as a causative factor in the pathogenesis of urological complications after radical hysterectomy.


Cesium irradiation Radical hysterectomy Urodynamic investigation 


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Copyright information

© The International Urogynecology Journal 1992

Authors and Affiliations

  • A. B. F. Crane-Elders
    • 1
    • 2
  • F. M. Kauer
    • 1
    • 3
  • J. Bouma
    • 4
  • J. Janssens
    • 1
  1. 1.State University Hospital GroningenGroningenThe Netherlands
  2. 2.Academic Hospital NijmegenGroningenThe Netherlands
  3. 3.Martini Hospital GroningenGroningenThe Netherlands
  4. 4.State University HospitalGroningenThe Netherlands

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