Gaballa Khaled, Denewer Adel, Khater Ashraf, Gallotta Valerio, Conte Carmine, Federico Alex, Elfeki Hossam, Scambia Giovanni
a Surgical Oncology , Oncology Center Mansoura University , Mansoura , Egypt.
b Department of Gynecologic Oncology, Gynecologic Oncology , Catholic University of the Sacred Heart , Rome , Italy.
J Obstet Gynaecol. 2019 Aug;39(6):788-792. doi: 10.1080/01443615.2019.1584883. Epub 2019 Apr 22.
The aim of the study is to evaluate the feasibility of early postoperative bladder catheter removal without prior bladder-training exercises after laparoscopic nerve sparing radical hysterectomy (LNSRH). The post-operative bladder catheterisation period of 30 patients who underwent LNSRH at two institutes in Egypt and Italy were prospectively evaluated with postoperative drainage of the bladder through a Foley catheter for two days without performing bladder-training exercise. The median duration for postoperative bladder catheterisation was 3.5 (3-5) days. Within the fifth postoperative day, 82.7% had a PVR urine volume less than 100 ml. None of the patients had PVR urine more than 100 ml more than 10 days after the operation with no need for self-catheterisation. These results support early postoperative bladder catheter removal without prior bladder-training exercises following LNSRH. IMPACT STATEMENT Bladder-training exercise was used routinely following radical hysterectomy (RH) operations before bladder catheter removal. Only two studies reported that these exercises could be omitted, but one study was done on both laparoscopic and open RH patients and the other did not show whether the operation was nerve-sparing and whether it was done by laparoscopy or open technique. This study's results support early postoperative bladder catheter removal without prior bladder-training exercises after laparoscopic nerve sparing RH. Excluding the unnecessary procedure of bladder training, which is time- and effort-consuming, after the operation.
本研究的目的是评估腹腔镜保留神经根治性子宫切除术（LNSRH）后不进行术前膀胱训练而早期拔除术后膀胱导管的可行性。对在埃及和意大利两家机构接受LNSRH的30例患者的术后膀胱导管插入期进行了前瞻性评估，通过Foley导管进行术后膀胱引流两天，且不进行膀胱训练。术后膀胱导管插入的中位持续时间为3.5（3 - 5）天。在术后第五天内，82.7%的患者残余尿量小于100ml。术后10天内，无一例患者残余尿量超过100ml，且无需自行导尿。这些结果支持LNSRH后不进行术前膀胱训练而早期拔除术后膀胱导管。影响声明 在根治性子宫切除术（RH）后拔除膀胱导管之前，常规进行膀胱训练。仅有两项研究报告可以省略这些训练，但一项研究针对腹腔镜和开放RH患者，另一项研究未表明手术是否保留神经以及是通过腹腔镜还是开放技术进行的。 本研究结果支持腹腔镜保留神经RH后不进行术前膀胱训练而早期拔除术后膀胱导管。 术后省去了耗时费力的不必要的膀胱训练程序。
