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

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objectives

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.

Interventions

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.

Results

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.

Conclusions

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.

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Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy

    Francesco Fanfani, Barbara Costantini, Floriana Mascilini, Giuseppe Vizzielli, Valerio Gallotta, Massimo Vigliotta & Giovanni Scambia

  2. Department of Biomedicine and Prevention, Section of Obstetric and Gynecology, Tor Vergata, University of Rome, Rome, Italy

    Emilio Piccione

  3. Division of Minimally Invasive Gynecological Surgery, Department of Surgery, St. Maria Hospital, University of Perugia, Terni, Italy

    Anna Fagotti

Authors
  1. Francesco Fanfani
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  2. Barbara Costantini
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  3. Floriana Mascilini
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  4. Giuseppe Vizzielli
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  5. Valerio Gallotta
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  6. Massimo Vigliotta
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  7. Emilio Piccione
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  8. Giovanni Scambia
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  9. Anna Fagotti
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Corresponding author

Correspondence to Francesco Fanfani.

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Fanfani, F., Costantini, B., Mascilini, F. et al. Early postoperative bladder training in patients submitted to radical hysterectomy: is it still necessary? A randomized trial. Arch Gynecol Obstet 291, 883–888 (2015). https://doi.org/10.1007/s00404-014-3500-5

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  • DOI: https://doi.org/10.1007/s00404-014-3500-5

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