Postvoid Residual Volume After Radical Hysterectomy for Early-Stage Cervical Cancer: Predictive Factors and a...

Our study evaluated the time to normalization of postvoid residual volume after radical hysterectomy and identified risk factors for postoperative bladder dysfunction. We also aimed to establish a predictive threshold for bladder dysfunction on the third postoperative day to develop a decision-making algorithm for postoperative voiding management.

This retrospective, single-center study included early-stage cervical cancer patients undergoing type B1 or C1 radical hysterectomy. Factors associated with elevated postvoid residual volume were analyzed using logistic regression, and the threshold was determined using the Youden index.

67 patients were included: 36 patients (53.7%) underwent C1 radical hysterectomy and 31 (46.3%) B1. At discharge, 13 (19.4%) patients required a catheter: 8 (61.5%) required intermittent catheterization, 5 (38.5%) had a Foley catheter. By postoperative day 3, 49 (73.1%) patients recovered their voiding function. The median time to postvoid residual volume recovery was 1 day (IQR: 1-2) for type B1 and 2.5 days (IQR: 2-5) for type C1 (p < 0.01). Compared with B1, C1 radicality was independently associated with a higher risk of postoperative voiding dysfunction (OR = 11.46; 95% CI: 1.75-75.24; p < 0.05). Based on these findings, we propose an algorithm for risk-adapted postoperative voiding management: B1 patients can safely have catheters removed on postoperative day 1 without a voiding trial, whereas C1 patients require one. C1 patients with postvoid residual volume ≥170 mL should have delayed catheter removal.

Surgical radicality is a risk factor for postoperative bladder dysfunction. In type C1 radical hysterectomy, a postvoid residual volume ≥170 mL on the first postoperative day identifies patients at high risk of delayed recovery, supporting a tailored approach to postoperative voiding management.