Susanne Maigaard Axelsen

Urodynamic and ultrasound characteristics of incontinence after radical hysterectomy

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  • Susanne Maigaard Axelsen, Department of Gynecology and Obstetrics, Aarhus University Hospital, Skejby Hospital, Aarhus, Denmark. susanne.axelsen@dadlnet.dk, Danmark
  • Karl Moeller Bek, Danmark
  • Lone Kjeld Petersen
  • Susanne Maigaard Axelsen

AIMS: To test whether symptoms of urinary incontinence after radical hysterectomy could be objectified with urodynamics and ultrasound.

METHODS: This case-control study comprised 100 women who underwent radical hysterectomy for cervical cancer without post-operative radiotherapy. Fifty women reporting urinary incontinence were matched with 50 women reporting continence. All women were assessed with ultrasound of the bladder neck movements and urodynamics.

RESULTS: No differences were found in ultrasound or urodynamic findings regarding mobility of the bladder neck, maximal detrusor pressure, post-voiding residual urine, flow of urine, or bladder capacity. A significant reduction in urethral pressure at rest and at contraction among the incontinent women was, however, demonstrated. Among urge-incontinent women, urethral pressure at rest was significantly lower than among continent and stress-incontinent women, respectively. Stress-incontinent women had significantly lower urethral pressure at contraction than did urge-incontinent and continent women.

CONCLUSIONS: No differences in urodynamic or ultrasound findings were observed between the two groups, except for an overall difference in the intraurethral pressure. A decrease in the urethral pressure could contribute to the characterization of incontinence after radical hysterectomy, indicating that the urethral sphincter mechanism plays a role in the pathophysiology. In this study design, the mobility of the bladder neck did not play any role.

OriginalsprogEngelsk
TidsskriftNeurourology and Urodynamics
Vol/bind26
Nummer6
Sider (fra-til)794-9
Antal sider6
ISSN0733-2467
DOI
StatusUdgivet - 2007

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