Gulati N, Kumar V J, Barsaul M, Yadav S P
Department of Obstetrics & Gynaecology, Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
Indian J Cancer. 2001 Jun-Dec;38(2-4):96-102.
Wertheim 's hysterectomy is likely to cause damage to innervation and anatomical support of the lower urinary tract. Urodynamic assessment was done in twenty patients of histopathologically proven cancer cervix who were about to undergo Wertheim's hysterectomy. The study was performed preoperatively, in the immediate postoperative period and six weeks after surgery. Urodynamic study included uroflowmetry, cystometry and urethral pressure profile. Urinary symptoms were also corelated with the urodynamic profile. It was concluded that the bladder was hypertonic in the immediate postoperative period and urethral closure pressures were low. Some regeneration of damaged nerve fibres was found to occur during the 6-8 weeks after surgery resulting in some improvement in sensory and motor functions of the bladder Post operatively continuous catheter drainage appeared to be the most important part of management of hypertonic bladder and the duration was individualised on the basis of urodynamic investigations.
韦特海姆子宫切除术可能会对下尿路的神经支配和解剖学支撑造成损伤。对20例经组织病理学证实为宫颈癌且即将接受韦特海姆子宫切除术的患者进行了尿动力学评估。该研究在术前、术后即刻及术后六周进行。尿动力学研究包括尿流率测定、膀胱测压和尿道压力描记。还将排尿症状与尿动力学特征进行了关联。得出的结论是,术后即刻膀胱呈高张状态,尿道闭合压较低。发现术后6 - 8周受损神经纤维会出现一些再生,导致膀胱的感觉和运动功能有所改善。术后持续导尿引流似乎是高张性膀胱管理中最重要的部分,其持续时间根据尿动力学检查结果个体化确定。