How to avoid bladder dysfunction after radical hysterectomy for cervical cancer

After radical hysterectomy for cervical cancer, some patients may experience bladder dysfunction, which may manifest as stress urinary incontinence, cystocele, urethral shortening, dysuria, urinary retention, loss of urinary sensation, detrusor muscle paralysis and other symptoms.

Surgical damage to the bilateral sympathetic and parasympathetic nerves that control the bladder and urethra, or loss of support for the bladder neck and excessive bladder extension caused by hysterectomy are the causes of bladder dysfunction in patients after radical hysterectomy for cervical cancer. In order to make the operation thorough and improve the efficacy, radical hysterectomy for cervical cancer must remove the primary uterine lesion and the surrounding tissues that may be invaded. The range of resection of the aortosacral ligament of the uterus should be more than 3 cm away from the cervix, which will inevitably cut off the nerves that control the bladder, causing bladder paralysis and leading to its dysfunction.

Some clinical scholars believe that the amount of uterine cardiosacral ligament removed is proportional to the recovery of bladder function, and that too deep separation of the rectum and lateral bladder fossa, too deep removal of the sacral ligament, and damage to the nerves that control the bladder are the main causes of urinary retention in patients. Therefore, in order to prevent the occurrence of urinary retention, doctors should determine the corresponding resection range during surgery according to the different stages of cervical cancer, which can not only ensure the thoroughness of the lesion removal and improve the efficacy, but also reduce the incidence of urinary retention.

At the same time, a urinary catheter should be left in place for 7-8 days after surgery, with an intermittent opening for 1-2 days to mechanically fill and empty the bladder and remove the catheter 8-10 days after surgery. If the residual urine exceeds 100 ml, the catheter should continue to be left in place and replaced weekly. If the resection is too extensive, the duration can be extended to 4-6 weeks. Various measures can be taken to effectively prevent and control infection, strengthen bladder muscle contraction, calm and relieve spasm, and reduce bladder tension.