Manzl J, Marberger F, Hetzel H, Klammer J, Geir W, Dapunt O
Geburtshilfe Frauenheilkd. 1981 Feb;41(2):145-50.
1972 to 1977 141 patients at the university department of gynecology and obstetrics in Innsbruck had radical abdominal hysterectomies according to Latzko because of carcinoma of the cervix uteri state I-IIa. 111 (78.8%) patients without recurrence of carcinoma were investigated without recurrence of carcinoma were investigated in the period of 2 to 36 months after operation in a modern urodynamic testing unit to state functional troubles of the lower urinary tract. We judged the sensibility of the bladder, the incidence of urinary incontinence, residual urine determinations and the frequency of infections of the lower urinary tract after radical hysterectomies. In particular we were interested in the urodynamic investigation (spontaneous flow rate and uroflow-metrie after bladder filling, liquid cystometry and simultaneous measurement of the pressure in the rectum for a faithful expression of the detrusor pressure). Based on these investigations we could indicate a typical type of troubles after radical abdominal hysterectomies, which partly depends on lesions of the autonomous nerval system of the lower urinary tract. 89.5% of all these patients within the first year after operation could not feel any desire to void although the bladder was full. Longer than one year after operation we could find the same symptom in 45.5%--recovery in part seems to be possible. Moreover we could find unnoticed urinary loss, residual urine and infections of the lower urinary tract (24.7%) in higher incidence compared with a control group. Because of our investigation we could work out advice for prevention and therapy of functional troubles of the lower urinary tract after radical abdominal hysterectomy.
1972年至1977年，因子宫颈癌I - IIa期，因斯布鲁克大学妇产科的141例患者接受了Latzko式根治性腹式子宫切除术。111例（78.8%）无癌复发的患者在术后2至36个月期间，于现代化尿动力学检测单元接受了无癌复发情况的调查，以评估下尿路的功能障碍。我们判断了膀胱的敏感性、尿失禁的发生率、残余尿量测定以及根治性子宫切除术后下尿路感染的频率。我们尤其关注尿动力学检查（自发尿流率以及膀胱充盈后的尿流测定、液体膀胱测压以及同时测量直肠压力以准确反映逼尿肌压力）。基于这些调查，我们能够指出根治性腹式子宫切除术后典型的功能障碍类型，其部分取决于下尿路自主神经系统的损伤。所有这些患者中，89.5%在术后第一年内尽管膀胱充盈却无排尿欲望。术后一年以上，我们发现45.5%的患者有相同症状——部分恢复似乎是可能的。此外，与对照组相比，我们发现未被察觉的尿失禁、残余尿以及下尿路感染（24.7%）的发生率更高。基于我们的调查，我们能够制定出根治性腹式子宫切除术后下尿路功能障碍的预防和治疗建议。
