[Advances in the prevention and control of urologic complications of cervix cancer. 2. Bladder-function disorders]

By means of 386 comparative cystometries hypertensive reactions were recorded from the urinary bladder both following total and radical vaginal hysterectomy. Hypertension was most strongly pronounced over the first two weeks after operation and receded spontaneously during the third and fourth weeks. That increased intravesical pressure, therefore, was attributed primarily to the surgical trauma and its inevitably accompanying irritation of the bladder. Predominant parasympathetic denervation of the bladder by radical surgery was found to be relevant, first of all, during micturation. Reduced sense of emptying the bladder and sympathetically induced disturbances in the correlations between detrusor and the urethrovesical region favoured the formation of residual urine. Its early therapy, using cholinergics, is becoming increasingly problematic. Intensive control of infections and persistent continuation of catheterisation, until the autonomously functioning bladder has got adjusted to its changed conditions, so far remain to be the most dependable approaches to prophylaxis and therapy of micturation disorders following radical surgery. In severe cases more recent pharmacological and neurohistochemical findings regarding selective effectiveness of alpha-receptor blockers and beta-stimulators in neurogenic bladder may open new therapeutic ways.