Zur Frage der funktionellen Störungen des unteren Harntraktes nach der abdominalen Radikaloperation des Zervixkrebses

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Abstract
196 women underwent radical abdominal hysterectomy with pelvic lymphadenectomy for cervical cancer of the clinical stages Ib to IIb, at the University Department of Obstetrics and Gynaecology in Graz during 1977 to 1982. 51 patients without recurring cancer and without subsequent radiotherapy were followed up for functional disturbances of the efferent urinary tract. The time interval between surgery and follow-up being 6 to 60 months. Follow-up examination consisted of palpation and, in addition, specific anamnesis based on a specially designed questionnaire, determination of residual urine, control of urine culture, and urodynamic measurement. Furthermore, urethro-cystoscopy and excretion urography were performed in all patients. 21.6% of the patients were completely free from complaints. In contrast, 78.4% of the women reported more or less pronounced signs and symptoms: first of all, delayed spontaneous micturition (78.4% of the cases), and, secondly, stress incontinence (58.8%) and a reduced desire to urinate (47.1%). Enhanced amounts of residual urine were measured in 35.3% of the women, whereas significant bacteriuria occurred in 31.4% of the women. Urodynamic measurement resulted in normal intravesical pressure values in 23 women (45.1%). On the other hand, hypotonic intravesical pressure was seen in 20 patients (39.2%) and hypertonic pressure in 8 women (15.7%). In all patients micturition was disturbed both in respect of urine flow and micturition time. 41 (80.4%) urethro-cystoscopic findings and 41 intravenous pyelography were in the normal range. The complaints reported by the patients were mostly not of special significance for them, since 34 women (66.6%) were greatly satisfied with their condition. The results are described in detail and are discussed.

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