CYSTOMANOMETRY – ONE OF THE ASSESSMENT METHODS OF THE URODYNAMIC INDEXES IN PATIENTS WITH INFILTRATIVE CERVICAL CANCER

Tetyana Dermenzhy, Valentin Svintsitsky, Sergey Nespryadko, Oleksandr Iatsyna, Oleksandr Kabanov

Abstract


Aim: To evaluate contractile function of urinary bladder in patients with infiltrative cervical cancer after nerve-sparing radical hysterectomy (NSRH).

Patients and Methods: Ninety patients with infiltrative cervical cancer were treated with nerve-sparing radical hysterectomy (n=45, NSRH group), or radical hysterectomy (RHE III) without preservation of pelvic autonomic plexuses (n=45, RHE group). Cystomanometry was carried out using urodynamic apparatus “Uro-Pro” by standard method.

Results: Using cystomanometry, we have evaluated the main urodynamic indexes such as pressure upon bladder filling (P1), first vesical tenesmus pressure (P2); change of detrusor pressure upon change of bladder volume (P), volume of urinary bladder (V), and complience of urinary bladder wall (C) at preoperative period and postoperative period in both groups of patients. While at preoperative period P1 indexes did not differ significantly between the groups, after NSRH performance, P1 values were significantly higher than P1 values in the group of patients treated with RHE III (8,29±1,1 cm H2O versus 3,51±0,8 cm H2O  (р<0,05)). P2 indexes in patients from both groups before and after surgical treatment differed significantly and were 6,82±0,4 cm H2O and 12,27±1,2 cm H2O (р<0,05) in NSRH group, and 5,44±0,6 cm H2O and 10,62±1,1 cm H2O (р<0,05) in RHE III group. The P value in both patients groups before and after the surgical treatments was significantly different, and demonstrated a gradual elevation of urinary bladder pressure, especially in the patients from RHE III treated group. Urinary bladder volume at preoperative and postoperative periods in NSRH-treated group remained practically unaltered (209,78±14,2 ml and 216,86±14,9 ml (р>0,5) respectively), while in the patients from RHE III-treated group after surgical treatment an urinary bladder volume significantly decreased from 188,4±10,5 ml to 161,9±9,8 ml (р<0,05). An analysis of compliance of urinary bladder wall (C) has shown that after surgical treatment in RHE group C value decreased by 75% while in NSE group this index decreased just by 25%.

Conclusions: The data of urodynamic study evidence the better preservation of urinary bladder functions in patients with infiltrative cervical cancer after NSRH than in the patients treated with RHE III. 


Keywords


infiltrative cervical cancer; nerve-sparing radical hysterectomy; cystomanometry

Full Text:

PDF

References


Laterza, R. M., Sievert, K.-D., de Ridder, D., Vierhout, M. E., Haab, F., Cardozo, L. et. al. (2014). Bladder function after radical hysterectomy for cervical cancer. Neurourology and Urodynamics, 34 (4), 309–315. doi: 10.1002/nau.22570

Axelsen, S. M., Petersen, L. K. (2006). Urogynaecological dysfunction after radical hysterectomy. European Journal of Surgical Oncology (EJSO), 32(4), 445–449. doi: 10.1016/j.ejso.2006.01.017

Digesu, G. A., Basra, R., Khullar, V., Hendricken, C., Camarata, M., Kelleher, C. (2009). Bladder sensations during filling cystometry are different according to urodynamic diagnosis. Neurourology and Urodynamics, 28 (3), 191–196. doi: 10.1002/nau.20627

Hsiao, S.-M., Sheu, B.-C., Lin, H.-H. (2007). Sequential assessment of urodynamic findings before and after transobturator tape procedure for female urodynamic stress incontinence. International Urogynecology Journal, 19 (5), 627–632. doi: 10.1007/s00192-007-0488-4

Walz, J., Burnett, A. L., Costello, A. J., Eastham, J. A., Graefen, M., Guillonneau, B. et. al. (2010). A Critical Analysis of the Current Knowledge of Surgical Anatomy Related to Optimization of Cancer Control and Preservation of Continence and Erection in Candidates for Radical Prostatectomy. European Urology, 57 (2), 179–192. doi: 10.1016/j.eururo.2009.11.009

Wang, W., Li, B., Zuo, J., Zhang, G., Yang, Y., Zeng, H. et. al. (2014). Evaluation of pelvic visceral functions after modified nerve-sparing radical hysterectomy. Chin Med J, 127, 696–701.

Brooks, R. A., Wright, J. D., Powell, M. A., Rader, J. S., Gao, F., Mutch, D. G., & Wall, L. L. (2009). Long-term assessment of bladder and bowel dysfunction after radical hysterectomy. Gynecologic Oncology, 114 (1), 75–79. doi: 10.1016/j.ygyno.2009.03.036

Ceccaroni, M., Roviglione, G., Spagnolo, E., Casadio, P., Clarizia, R., Peiretti, M. et. al. (2012). Pelvic dysfunctions and quality of life after nerve-sparing radical hysterectomy: a multicenter comparative study. Anticancer Res, 32, 581–588.

Wu, J., Liu, X., Hua, K., Hu, C., Chen, X., Lu, X. (2010). Effect of Nerve-Sparing Radical Hysterectomy on Bladder Function Recovery and Quality of Life in Patients With Cervical Carcinoma. International Journal of Gynecological Cancer, 20 (5), 905–909. doi: 10.1111/igc.0b013e3181df99c0

Chuang, F. C., Kuo, H. C. (2007). Urological Complications of Radical Hysterectomy for Uterine Cervical Cancer. Incont Pelvic Floor Dysfunct, 1 (3), 77–80.

Wallner, L. P., Porten, S., Meenan, R. T., O’Keefe Rosetti, M. C., Calhoun, E. A., Sarma, A. V., Clemens, J. Q. (2009). Prevalence and Severity of Undiagnosed Urinary Incontinence in Women. The American Journal of Medicine, 122 (11), 1037–1042. doi: 10.1016/j.amjmed.2009.05.016

Fujii, S., Takakura, K., Matsumura, N., Higuchi, T., Yura, S., Mandai, M. et. al. (2007). Anatomic identification and functional outcomes of the nerve sparing Okabayashi radical hysterectomy. Gynecologic Oncology, 107 (1), 4–13. doi: 10.1016/j.ygyno.2007.08.076

Plotti, F., Angioli, R., Zullo, M. A., Sansone, M., Altavilla, T., Antonelli, E. et. al. (2011). Update on urodynamic bladder dysfunctions after radical hysterectomy for cervical cancer. Critical Reviews in Oncology/Hematology, 80 (2), 323–329. doi: 10.1016/j.critrevonc.2010.12.004

Zhu, T., Yu, A. J., Shou, H. F., Chen, X., Zhu, J. Q., Yang, Z. Y. et. al. (2011). Feasibility of unilateral or bilateral nerve-sparing radical hysterectomy in patients with cervical cancer and evaluation of the post-surgery recovery of the bladder and rectal function. Zhonghua zhong liu za zhi [Chinese journal of oncology], 33 (1), 53–57.

Long, R. M., Giri, S. K., Flood, H. D. (2008). Current concepts in female stress urinary incontinence. The Surgeon, 6 (6), 366–372. doi: 10.1016/s1479-666x(08)80010-8

Uccella, S., Laterza, R., Ciravolo, G., Volpi, E., Franchi, M., Zefiro, F. et. al. (2007). A comparison of urinary complications following total laparoscopic radical hysterectomy and laparoscopic pelvic lymphadenectomy to open abdominal surgery. Gynecologic Oncology, 107 (1), S147–S149. doi: 10.1016/j.ygyno.2007.07.027

Basu, M., Duckett, J. (2009). The effect of urethral dilatation on pressure flow studies in women with voiding dysfunction and overactive bladder. International Urogynecology Journal, 20 (9), 1073–1077. doi: 10.1007/s00192-009-0904-z

Van Leijsen, S. A., Kluivers, K. B., Mol, B. W. J., Broekhuis, S. R., Milani, F. L., Vaart, C. H. van der et. al. (2009). Protocol for the value of urodynamics prior to stress incontinence surgery (VUSIS) study: a multicenter randomized controlled trial to assess the cost effectiveness of urodynamics in women with symptoms of stress urinary incontinence in whom surgical treatment is considered. BMC Women’s Health, 9 (1), 9–22. doi: 10.1186/1472-6874-9-22

Chuang, F.-C., Kuo, H.-C. (2009). Management of Lower Urinary Tract Dysfunction After Radical Hysterectomy With or Without Radiotherapy for Uterine Cervical Cancer. Journal of the Formosan Medical Association, 108 (8), 619–626. doi: 10.1016/s0929-6646(09)60382-x

Manchana, T., Prasartsakulchai, C., Santingamkun, A. (2009). Long-term lower urinary tract dysfunction after radical hysterectomy in patients with early postoperative voiding dysfunction. International Urogynecology Journal, 21 (1), 95–101. doi: 10.1007/s00192-009-0996-5




DOI: http://dx.doi.org/10.21303/2504-5679.2016.00116

Refbacks

  • There are currently no refbacks.




Copyright (c) 2016 Tetyana Dermenzhy, Valentin Svintsitsky, Sergey Nespryadko, Oleksandr Iatsyna, Oleksandr Kabanov

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

ISSN 2504-5679 (Online), ISSN 2504-5660 (Print)