The influence of the pelvic plexus preservation under radical hysterectomy in patients with infiltrative cervical cancer on the contractile function of the urinary bladder
T. Dermenzhy, V. Svintsitsky, I. Schepotin, O. Iatsyna, O. Kabanov
National Cancer Institute, Kyiv, Ukraine
Aim: To justify the need to preserve pelvic plexus under radical hysterectomy (RH) in patients with infiltrative cervical carcinoma (CC). Patients and Methods: 30 patients with infiltrative CC (mean age 32.7±4.9 years) which underwent RH were enrolled into study: in 15 patients (group I) RH was performed with preservation of the pelvic plexus and in 15 patients (group II) RH was performed by standard method without preservation of the pelvic nerve plexus. The study protocol was approved by Ethical committee permission of National Cancer Institute (Kyiv, Ukraine). Cytomanometric assessment of urinary bladder’s contractile function after RH with preserving of the pelvic plexus in infiltrative CC patients was performed by using urodynamic stand URO-PRO according to the standard procedure. Results: According to cytomanometric data contractile function of urinary bladder was fully restored in 2–3 days after RH in 80% of group I patients and only in 20% of group II patients. In patients of group II the function of the lower urinary tract restored within 7 days after RH, in 20% of these patients persistent paresis of the urinary bladder detrusor was observed, which partially restored from 7 to 21 days. It indicates strong neurological disorders of contractile function of urinary bladder under surgical trauma of pelvic plexus during standard RH. Conclusion: Recovery of the contractile function of urinary bladder in 24 hours after RH justifies necessity of the pelvic plexus preservation during RH in patients with infiltrative CC.
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