Ralph G, Lichtenegger W
Universitäts-Frauenklinik, Graz.
Zentralbl Gynakol. 1988;110(18):1124-31.
Radical abdominal hysterectomy causes functional disorders of the lower urinary tract. We prospectively evaluated urinary dysfunction in 72 women before 2 weeks, 6 months and 1 year after surgery. The results were compared to those of 10 women who underwent simple abdominal hysterectomy. After radical abdominal hysterectomy 63% of our patients had impaired or absent bladder sensibility at 6 months. Bladder compliance was abnormal in 79% patients at 14 days and in 60% after 6 months and 1 year. Preoperative urethral stress profiles were performed in 58 patients. 69% of the stress profiles showed continence, 31% stress incontinence. 11 initially continent women (22%) developed stress incontinence. We attribute post-operative stress incontinence to surgical trauma, edema, haematoma, scartissue that restricts mobility of the bladder neck.
根治性腹式子宫切除术会导致下尿路功能障碍。我们前瞻性地评估了72名女性在手术前2周、术后6个月和1年时的排尿功能障碍情况。并将结果与10名接受单纯腹式子宫切除术的女性进行了比较。根治性腹式子宫切除术后,63%的患者在6个月时膀胱感觉受损或缺失。79%的患者在术后14天时膀胱顺应性异常,6个月和1年后这一比例为60%。对58例患者进行了术前尿道压力测定。69%的压力测定显示为尿失禁,31%为压力性尿失禁。11名最初尿失禁的女性(22%)出现了压力性尿失禁。我们将术后压力性尿失禁归因于手术创伤、水肿、血肿、瘢痕组织,这些因素限制了膀胱颈的活动。