Changes in urethral closure pressure after radical hysterectomy for cervical cancer

The behaviour of the urethral closure pressure at rest (UCP) both before and 14 days and 3 months after radical surgery for cervical cancer was examined. The results were compared with those of other authors. In contrast to the latter we were only able to establish a constant pressure drop in patients using a transurethral catheter at the time of the first postoperative measurement. Patients using a suprapubic catheter showed non-uniform postoperative UCP-changes. This pattern was comparable to that found after simple abdominal hysterectomy, performed for other reasons, in which a transurethral catheter had been in place for a maximum of 60 h. In contrast to our predecessors we were unable to confirm a causal relationship between surgical damage to the sympathetic system and postoperative falls in pressure, except after extremely radical surgery. The cause appears to be a complex process involving wound healing problems (edema, infection, scar formation and organ position changes) and direct traumatization of the urethra (transurethral catheter).