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[宫颈癌根治性腹部手术后下尿路功能障碍]

[Functional disorders of the lower urinary tract following a radical abdominal operation in cervical cancer].

作者信息

Ralph G, Burmucic R

出版信息

Geburtshilfe Frauenheilkd. 1985 Sep;45(9):625-9. doi: 10.1055/s-2008-1036381.

DOI:10.1055/s-2008-1036381
PMID:4054544
Abstract

196 women underwent radical abdominal hysterectomy with pelvic lymphadenectomy for cervical cancer of the clinical stages Ib to IIb, at the University Department of Obstetrics and Gynaecology in Graz during 1977 to 1982. 51 patients without recurring cancer and without subsequent radiotherapy were followed up for functional disturbances of the efferent urinary tract. The time interval between surgery and follow-up being 6 to 60 months. Follow-up examination consisted of palpation and, in addition, specific anamnesis based on a specially designed questionnaire, determination of residual urine, control of urine culture, and urodynamic measurement. Furthermore, urethro-cystoscopy and excretion urography were performed in all patients. 21.6% of the patients were completely free from complaints. In contrast, 78.4% of the women reported more or less pronounced signs and symptoms: first of all, delayed spontaneous micturition (78.4% of the cases), and, secondly, stress incontinence (58.8%) and a reduced desire to urinate (47.1%). Enhanced amounts of residual urine were measured in 35.3% of the women, whereas significant bacteriuria occurred in 31.4% of the women. Urodynamic measurement resulted in normal intravesical pressure values in 23 women (45.1%). On the other hand, hypotonic intravesical pressure was seen in 20 patients (39.2%) and hypertonic pressure in 8 women (15.7%). In all patients micturition was disturbed both in respect of urine flow and micturition time. 41 (80.4%) urethro-cystoscopic findings and 41 intravenous pyelography were in the normal range. The complaints reported by the patients were mostly not of special significance for them, since 34 women (66.6%) were greatly satisfied with their condition. The results are described in detail and are discussed.

摘要

1977年至1982年期间,在格拉茨大学妇产科,196名患有临床分期为Ib至IIb期宫颈癌的女性接受了根治性腹式子宫切除术及盆腔淋巴结清扫术。对51例无癌症复发且未接受后续放疗的患者进行了随访,以观察其传出尿路的功能障碍情况。手术与随访之间的时间间隔为6至60个月。随访检查包括触诊,此外,还根据一份专门设计的问卷进行详细问诊、测定残余尿量、检查尿培养以及进行尿动力学测量。此外,所有患者均接受了尿道膀胱镜检查和排泄性尿路造影。21.6%的患者完全没有不适症状。相比之下,78.4%的女性报告有或多或少明显的体征和症状:首先是排尿延迟(78.4%的病例),其次是压力性尿失禁(58.8%)和排尿欲望降低(47.1%)。35.3%的女性测量出残余尿量增加,而31.4%的女性出现显著菌尿。尿动力学测量结果显示,23名女性(45.1%)膀胱内压值正常。另一方面,20名患者(39.2%)出现膀胱内压降低,8名女性(15.7%)出现膀胱内压升高。所有患者在尿流和排尿时间方面的排尿功能均受到干扰。41例(80.4%)尿道膀胱镜检查结果和41例静脉肾盂造影结果在正常范围内。患者报告的不适症状大多对她们来说没有特别重要的意义,因为34名女性(66.6%)对自己的状况非常满意。详细描述并讨论了结果。

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[Functional disorders of the lower urinary tract following a radical abdominal operation in cervical cancer].[宫颈癌根治性腹部手术后下尿路功能障碍]
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[Functional disturbances of the lower urinary tract following radical surgery for cervical cancer (author's transl)].宫颈癌根治术后下尿路功能障碍(作者译)
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引用本文的文献

1
Urodynamics following radical abdominal hysterectomy for cervical cancer.
Arch Gynecol Obstet. 1988;243(4):215-20. doi: 10.1007/BF00932270.
2
Urological complications after radical hysterectomy with or without radiotherapy for cervical cancer.宫颈癌根治性子宫切除术后伴或不伴放疗的泌尿系统并发症
Arch Gynecol Obstet. 1990;248(2):61-5. doi: 10.1007/BF02389576.