Hayasaki M
Nihon Sanka Fujinka Gakkai Zasshi. 1982 Dec;34(12):2185-94.
In patients undergoing radical hysterectomy for cervical cancer, suprapubic bladder drainage by INGRAM's trocar catheter, which was removed when the postvoiding residual urine was under 30 ml, was attempted to reduce urinary tract infection. The incidence of urinary tract infection was 63.6% during 4 weeks after radical hysterectomy. Most appeared on the 7-14 th postoperative days. In the 6 months after radical hysterectomy, the incidence of significant bacteriuria in the suprapubic group was 9.4% compared to 21.1% in the urethral catheterized group. The difference between the two groups is significant. In view of these results the following is suggested: 1) The antibacterial mechanisms of both the urethra and urinary bladder are greatly weakened immediately following radical surgery for cervical cancer due to organic changes occurring as a result of the surgery. Urethrovesical reflux can regurgitate bacteria from the urethra into the bladder and cause infection despite the absence of urethral catheterization. 2) Indwelling and frequent urethral catheterization for residual urine may cause a chronic urethritis which may prove to be the greatest factor predisposing to urinary tract infection following radical surgery for cervical cancer.
对于接受宫颈癌根治性子宫切除术的患者，尝试采用英格拉姆套管导管进行耻骨上膀胱引流，当残余尿量低于30ml时拔除导管，以减少尿路感染。根治性子宫切除术后4周内尿路感染的发生率为63.6%。大多数感染出现在术后第7 - 14天。在根治性子宫切除术后6个月，耻骨上引流组显著菌尿的发生率为9.4%，而尿道插管组为21.1%。两组之间的差异具有显著性。鉴于这些结果，建议如下：1）由于宫颈癌根治性手术后发生的器质性改变，尿道和膀胱的抗菌机制在术后立即会大大减弱。尽管没有尿道插管，但尿道膀胱反流仍可将细菌从尿道反流至膀胱并导致感染。2）因残余尿而留置并频繁进行尿道插管可能会导致慢性尿道炎，这可能是宫颈癌根治性手术后易发生尿路感染的最大因素。
