Campbell Patrick, Casement Maire, Addley Susan, Dobbs Stephen, Harley Ian, Nagar Hans
a Regional Gynaecological Oncology Centre , Belfast City Hospital , Belfast , Northern Ireland.
J Obstet Gynaecol. 2017 Oct;37(7):970-972. doi: 10.1080/01443615.2017.1328668. Epub 2017 Aug 6.
Evidence to support prolonged catheterisation after radical hysterectomy is lacking. We sought to assess feasibility of a new protocol of early post-operative catheter removal following laparoscopic radical hysterectomy for cervical cancer. A retrospective review of post-operative bladder care in patients who underwent laparoscopic radical hysterectomy for cervical cancer was carried out. The post-operative bladder care protocol recommended catheter removal after 24-72 hours. Three consecutive post-void residual scans of less than 150 millilitres (ml) were considered evidence of normal voiding function. First line management of voiding dysfunction was clean intermittent self-catheterisation (CISC). Ninety-eight patients underwent laparoscopic radical hysterectomy for cervical cancer of whom 78 patients had catheter removal 24-72 hours post-operatively. The incidence of post-operative voiding dysfunction in this group was 44%, of whom 88% were managed with CISC and 82% regained normal voiding function. Average hospital stay was 4.2 days. The overall rate of long-term voiding dysfunction was 6%. Early catheter removal after laparoscopic radical hysterectomy appears to be both feasible and effective and compliments the ethos of enhanced patient recovery.
缺乏支持根治性子宫切除术后长期留置导尿管的证据。我们试图评估宫颈癌腹腔镜根治性子宫切除术后早期拔除导尿管新方案的可行性。对接受宫颈癌腹腔镜根治性子宫切除术患者的术后膀胱护理进行了回顾性研究。术后膀胱护理方案建议在24至72小时后拔除导尿管。连续三次排尿后残余尿量扫描少于150毫升（ml）被视为排尿功能正常的证据。排尿功能障碍的一线管理方法是清洁间歇性自我导尿（CISC）。98例患者接受了宫颈癌腹腔镜根治性子宫切除术，其中78例患者在术后24至72小时拔除导尿管。该组术后排尿功能障碍的发生率为44%，其中88%采用CISC治疗，82%恢复了正常排尿功能。平均住院时间为4.2天。长期排尿功能障碍的总体发生率为6%。腹腔镜根治性子宫切除术后早期拔除导尿管似乎既可行又有效，符合促进患者康复的理念。
