Immediate disorders of urination following radical hysterectomy in cervix cancer

Function of the lower urinary tract has been estimated in 23 patients with cervical carcinoma stage I-II before and after radical hysterectomy using simultaneous urethrocystometry with microtip transducer technique. The hypogastic nervous plexus could be preserved in 18 patients, but in 5 patients because of the increased radicality of the operation it was resected. Two weeks after operation no detrusor activity could be measured in all 5 patients with and in 13 out of 18 patients without plexus resection. In these patients a hypoactivity of the lower urinary tract with typical overflow incontinence and large residual urinary volume has been detected. Signs of a detrusor hyperactivity could be found in none of the 23 patients. The hyperactive bladder after radical hysterectomies often described is supposed to be a artefact caused by measuring technique. Because function of lower urinary tract has been examined in former studies with conventional cystometry with fast filling of bladder. The urethral function has been neglected more or less. The results obtained by simultaneous urethrocystometry support the assumption, that the primary reasons of the temporary and partly continuous changes of bladder and urethral function are pelvic hematomas, lymphatic vessel dysfunction, edema of bladder, direct surgical lesions of pelvic tissue and fibroses. Partial denervation may be joined partly. The most likely cause of cystometric changes is reduced distensibility of bladder and not hypertonic detrusor function.