Detrusor hypertonicity as a late complication of a Wertheim hysterectomy

An extended radical Wertheim hysterectomy is commonly used in the primary treatment of carcinoma of the cervix. Postoperative voiding dysfunction, characterized by a hypotonic or atonic detrusor, commonly occurs. It is not generally appreciated that hypertonic bladder dysfunction can also occur as a late postoperative complication. We describe 3 patients with postoperative detrusor hypertonia resulting in radiographic changes of the upper urinary tract. The etiology, diagnosis and management of detrusor hypertonia following a Wertheim hysterectomy are discussed.