Effects of radical hysterectomy with lymph nodes dissection on the lower urinary tract

In 18 patients with carcinoma of the urine cervix stage I-II lower urinary tract function was evaluated by urethral pressure profile measurements and flow measurements before and after radical hysterectomy. A specially designed surgical procedure was used which avoided transection of the nerve supply to the lower urinary tract. The most conspicuous finding was a significant decrease detrusor activity 14 days after the operation. Urethral function was almost unaffected. One year postoperatively all patients had an almost normal function of the lower urinary tract with no residuals. It is concluded that the decreased detrusor function observed 14 days after the operation was due to a direct trauma of the bladder and the bladderwall bringing about a myogenic injury which temporarily paralyzed the bladder. If special attention is paid during surgery to save the nerve supply to the bladder and the urethra, longlasting postoperative dysfunction of the lower urinary tract can be avoided after radical hysterectomy for carcinoma of the uterine cervix without compromising radicality.