Effects of different types of hysterectomies on postoperative urodynamics and lower urinary tract symptoms
Purpose: To evaluate the effects of different hysterectomies—simple hysterectomy (SH) and radical hysterectomy (RH) with or without radiation therapy (RT) on urodynamics and lower urinary tract symptoms (LUTS). Materials and Methods: Among patients who underwent urodynamic study between 2009 and 20...
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| Format: | Article |
| Language: | English |
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Korean Urological Association
2022-03-01
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| Series: | Investigative and Clinical Urology |
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| Online Access: | https://www.icurology.org/pdf/10.4111/icu.20210393 |
| _version_ | 1818138651483176960 |
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| author | Jung Hyun Shin Chan Hoon Gwak Min Uk Park Myung-Soo Choo |
| author_facet | Jung Hyun Shin Chan Hoon Gwak Min Uk Park Myung-Soo Choo |
| author_sort | Jung Hyun Shin |
| collection | DOAJ |
| description | Purpose: To evaluate the effects of different hysterectomies—simple hysterectomy (SH) and radical hysterectomy (RH) with or without radiation therapy (RT) on urodynamics and lower urinary tract symptoms (LUTS).
Materials and Methods: Among patients who underwent urodynamic study between 2009 and 2019, those with RH history due to cervical cancer and SH for uterine myoma were included. Clinical parameters were compared after adjusting clinically significant baseline variables with multivariate regression.
Results: A total of 289 patients (RH-only, n=57; RH+RT, n=72; SH, n=160) were included. Age at hysterectomy, gap between urodynamic study and hysterectomy, body mass index, hypertension and vaginal delivery history were adjusted. Stress urinary incontinence was more likely to occur in SH group (p<0.001), while urgency urinary incontinence was more prevalent in patients with history of RH (odds ratio [OR] 6.4, 95% confidence interval 2.171–18.855; p=0.001). There was no difference in OR of mixed urinary incontinence. Higher proportion of RH patients complained of recurrent urinary tract infection and voiding symptoms requiring intermittent catheterization. On urodynamic study, RH groups had lower maximal flow rate, larger post-void residual, decreased bladder sensation and impaired detrusor contractility (all p<0.001) than SH group. Adjuvant RT resulted in decreased compliance and decrease in volume of the first sense to void.
Conclusions: Predominant LUTS differed among patients after different types of hysterectomy. RH resulted in inefficient bladder emptying, leading to recurrent urinary tract infection and voiding symptoms requiring intermittent catheterization. Adjuvant RT exacerbated bladder compliance and increased bladder sensation. |
| first_indexed | 2024-12-11T10:15:35Z |
| format | Article |
| id | doaj.art-66ba09e5567e4c8d8f336b489e992050 |
| institution | Directory Open Access Journal |
| issn | 2466-0493 2466-054X |
| language | English |
| last_indexed | 2024-12-11T10:15:35Z |
| publishDate | 2022-03-01 |
| publisher | Korean Urological Association |
| record_format | Article |
| series | Investigative and Clinical Urology |
| spelling | doaj.art-66ba09e5567e4c8d8f336b489e9920502022-12-22T01:11:37ZengKorean Urological AssociationInvestigative and Clinical Urology2466-04932466-054X2022-03-0163210.4111/icu.20210393Effects of different types of hysterectomies on postoperative urodynamics and lower urinary tract symptomsJung Hyun Shin 0https://orcid.org/0000-0002-9399-5099Chan Hoon Gwak 1https://orcid.org/0000-0001-8396-3061Min Uk Park2https://orcid.org/0000-0002-5175-4000Myung-Soo Choo3https://orcid.org/0000-0002-3293-4751Department of Urology, Ewha Womans University Mokdong Hospital, Seoul, Korea.Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Purpose: To evaluate the effects of different hysterectomies—simple hysterectomy (SH) and radical hysterectomy (RH) with or without radiation therapy (RT) on urodynamics and lower urinary tract symptoms (LUTS). Materials and Methods: Among patients who underwent urodynamic study between 2009 and 2019, those with RH history due to cervical cancer and SH for uterine myoma were included. Clinical parameters were compared after adjusting clinically significant baseline variables with multivariate regression. Results: A total of 289 patients (RH-only, n=57; RH+RT, n=72; SH, n=160) were included. Age at hysterectomy, gap between urodynamic study and hysterectomy, body mass index, hypertension and vaginal delivery history were adjusted. Stress urinary incontinence was more likely to occur in SH group (p<0.001), while urgency urinary incontinence was more prevalent in patients with history of RH (odds ratio [OR] 6.4, 95% confidence interval 2.171–18.855; p=0.001). There was no difference in OR of mixed urinary incontinence. Higher proportion of RH patients complained of recurrent urinary tract infection and voiding symptoms requiring intermittent catheterization. On urodynamic study, RH groups had lower maximal flow rate, larger post-void residual, decreased bladder sensation and impaired detrusor contractility (all p<0.001) than SH group. Adjuvant RT resulted in decreased compliance and decrease in volume of the first sense to void. Conclusions: Predominant LUTS differed among patients after different types of hysterectomy. RH resulted in inefficient bladder emptying, leading to recurrent urinary tract infection and voiding symptoms requiring intermittent catheterization. Adjuvant RT exacerbated bladder compliance and increased bladder sensation.https://www.icurology.org/pdf/10.4111/icu.20210393hysterectomylower urinary tract symptomurinary incontinence |
| spellingShingle | Jung Hyun Shin Chan Hoon Gwak Min Uk Park Myung-Soo Choo Effects of different types of hysterectomies on postoperative urodynamics and lower urinary tract symptoms Investigative and Clinical Urology hysterectomy lower urinary tract symptom urinary incontinence |
| title | Effects of different types of hysterectomies on postoperative urodynamics and lower urinary tract symptoms |
| title_full | Effects of different types of hysterectomies on postoperative urodynamics and lower urinary tract symptoms |
| title_fullStr | Effects of different types of hysterectomies on postoperative urodynamics and lower urinary tract symptoms |
| title_full_unstemmed | Effects of different types of hysterectomies on postoperative urodynamics and lower urinary tract symptoms |
| title_short | Effects of different types of hysterectomies on postoperative urodynamics and lower urinary tract symptoms |
| title_sort | effects of different types of hysterectomies on postoperative urodynamics and lower urinary tract symptoms |
| topic | hysterectomy lower urinary tract symptom urinary incontinence |
| url | https://www.icurology.org/pdf/10.4111/icu.20210393 |
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