Prevalence of Neurogenic Bladder after Hysterectomy in Srinagarind Hospital

Abstract

Background and objective: The radical hysterectomy has been used to treat early stage (stage IB-IIA) of cervical carcinoma. Although the surgical technique has been improved, the pelvic plexus may be damaged during the operation causing urinary dysfunction. The previous study showed the odds of urinary incontinence after the hysterectomy was 1.4.  To the best of our knowledge, there is no study involving prevalence of neurogenic bladder after hysterectomy in Srinagarind hospital. Therefore, this study aimed to determine the prevalence and characteristics of neurogenic bladder following hysterectomy in patient with cervical carcinoma.

Material and Methods: All medical records of patients who diagnosed cervical carcinoma and underwent hysterectomy between 1 January 2550 to 31 May 2555 from database system of Srinagarind hospital, KhonKaen university were reviewed.

Results: One hundred and fifty two subjects were included. Most of them (82.2%) underwent radical hysterectomy. Sixty-four percent developed urinary dysfunction after radical hysterectomy. Of these, 52.8 % were transient neurogenic bladder. No urinary dysfunction was observed in patients underwent extrafascial hysterectomy, the average duration of postoperative in dwelling catheterization was shorter than transient neurogenic bladder in radical hysterectomy group significantly (24.5 +/- 11.6 VS 1.0 +/- 0.2 days; 95%CI 19.0 to 27.9).  Only 12% developed neurogenic bladder; 10.4% flaccid neurogenic bladder, 1.6% spastic neurogenic bladder.

Conclusions: Some patients developed neurogenic bladder following radical hysterectomy. Most common type of neurogenic bladder was flaccid type. Postoperative urinary function had better recovery after extrafascial hysterectomy.

Key words: Cervical carcinoma, Neurogenic bladder, Hysterectomy