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Effect of laparoscopic hysterectomy on bladder neck and urinary symptoms
Cheng-Yu Long1, Shih-Cheng Hsu, Tung-Pi Wu
1Department of Obstetrics and Gynaecology, Kaohsiung Municipal Hsiao Kang Hospital, Kaohsiung Medical University, Hsiao-Kang District, Kaosiung, Taiwan.
Objective:
To assess the effect of laparoscopic hysterectomy (LH) on the mobility and position of bladder neck (BN) and urinary symptoms.
Design:
We assessed the BN and urinary symptoms of 151 patients by introital ultrasonography and questionnaires before and after LH.
Sample:
One hundred and fifty-one women who underwent LH from June 1999 to June 2001.
Results:
A significant decrease was noted in the number of women exhibiting one or more urinary symptoms from 81 (53.6%) preoperatively to 58 (38.4%) postoperatively (P < 0.01). The incidence of urinary frequency, mild stress incontinence and nocturia decreased significantly after laparoscopic hysterectomy (P < 0.01). Changes in other urinary symptoms following hysterectomy showed no statistical significance (P > 0.05). During straining, the postoperative position of the BN localised more dorsally (P < 0.01) and the ventral mobility of the BN decreased significantly following surgery (P < 0.05). There was no significant difference in the location of the BN with respect to the pubis at rest and during straining, in the cephalocaudal direction, before and after hysterectomy (P > 0.05).
Conclusion:
Some patients experienced a substantial improvement of preoperative urinary symptoms following LH, partly as a result of a decrease in the hypermobility of BN.