CYSTOMANOMETRY – ONE OF THE ASSESSMENT METHODS OF THE URODYNAMIC INDEXES IN PATIENTS WITH INFILTRATIVE CERVICAL CANCER
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.
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Copyright (c) 2016 Tetyana Dermenzhy, Valentin Svintsitsky, Sergey Nespryadko, Oleksandr Iatsyna, Oleksandr Kabanov
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