Importance of urodynamic study before radical hysterectomy for cervical cancer

The aim of this study was to characterize the urodynamic findings in patients with cervical cancer before radical hysterectomy and to correlate the results with age, parity, menopausal status, and cancer stage.

All patients with cervical cancer before radical hysterectomy who underwent urodynamic study (UDS) from January 1996 through December 1998 were enrolled. Detailed history, physical examination, and multichannel UDS data including uroflowmetry, filling and voiding cystometry, stress urethral pressure profile, and 20-min pad test were obtained for each patient. The urodynamic findings of each patient were analyzed and correlated with age, parity, menopausal status, and cancer stage.

A total of 210 patients with cervical cancer were included in the study. The mean age was 48.9 +/- 10.5 years with a mean parity of 3.3 +/- 1.7. Forty-two percent (n = 88) of patients were menopausal, and 88% (n = 184) belonged to stage IB while 10% (n = 20) were stage IIA and 2% (n = 6) stage IIB. Urodynamic study showed that only 17% (n = 37) of the 210 patients were normal, 10% (n = 21) had voiding dysfunction, 45% (n = 94) had storing dysfunction, and 28% (n = 58) had both voiding and storing dysfunctions. In addition, 51% (n = 106) had urinary incontinence and 37% (n = 78) had genuine stress incontinence (GSI), 8% (n = 16) detrusor instability (DI), and 6% (n = 12) GSI/DI. Age, parity, and cancer stage did not show any significant differences among these four groups.

In this series, only 17% of patients with cervical cancer had normal urodynamic findings before radical hysterectomy.