Wertheim hysterectomy: a ten year experience.

This study covers 230 Wetheim operations. Sixty-seven patients had Stage II carcinoma (29.17%), and 163 patients had Stage I carcinoma (70.80%). Until 1968, x-ray treatment was used after the Vienna Wertheim operation, but since then the approach has changed. Tele- and brachio-cobalt therapy is now included. The operative death-rate was 0.96%. One patient died of peritonitis, another of renal uremia. In the Vienna Wertheim group, ureteric fistulae occurred in 7.23% of patients. With the introduction of mesentery and the ureter roof into the Wertheim procedure, ureteric fistulae have currently disappeared from the material examined (133 cases), although the operation was more radical than the classical Vienna Wertheim technique. Urography examination shows that changes are twice are frequent, and later anatomical changes in the urinary system are more than twice as frequent, with the Vienna Wertheim technique. A considerable number of early hydronephroses were found to have disappeared during the first year. Urography examination has shown that the mesentery of the ureter also has a beneficial effect on the flow of urine. It serves in the prophylaxis of fistulae, and prevents greater displacement of the ureter in the parametrial vacancies.