Bladder Function After Radical Hysterectomy for Cervical Cancer
Bladder Function After Radical Hysterectomy for Cervical Cancer
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DOI：
10.1002/nau.22570
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发表时间：
2015-04-01
影响因子：
2
通讯作者：
Koelbl, Heinz
中科院分区：
文献类型：
--
作者：
Laterza, Rosa M.;Sievert, Karl-Dietrich;Koelbl, Heinz
目的：为了报告根治性子宫切除术和保留神经技术对下尿路功能的影响在women.Methods：在Pubmed和Medline进行文献检索，使用关键词膀胱根治性子宫切除术后，保留神经根治性子宫切除术，根治性子宫切除术后排尿功能障碍。显著的结果和引文手动审查由authors.Results：支配下尿路的交感神经和副交感神经系统可能会被破坏，由于切除子宫骶骨和直肠阴道韧带，背侧和侧旁，膀胱子宫韧带的尾部，阴道。这支持了根治性手术后早期和晚期膀胱功能障碍的神经源性病因。膀胱疾病也与根治性手术的程度有关。广泛性子宫切除术后下尿路症状的神经病理生理学尚未完全了解。最近的数据强调了尿道括约肌压力在术后尿失禁病因中的作用。各种手术方法已被开发，以保持自主性pelvic nervations.Conclusions：神经保留技术似乎可以改善膀胱功能，而不影响总生存率。比较保留神经的广泛子宫切除术与标准手术的效果的研究在术后下尿路功能方面产生了令人鼓舞的结果。为了更好地理解根治性子宫切除术后膀胱功能障碍的复杂病理生理学，需要进行长期随访的临床试验。(C)2014 Wiley Periodicals，Inc.
Aim: To report the effects of radical hysterectomy and nerve-sparing techniques on lower urinary tract function in women.Methods: A literature search was performed in Pubmed and Medline using the keywords bladder after radical hysterectomy, nerve sparing radical hysterectomy, and urinary dysfunction following radical hysterectomy. Significant results and citations were reviewed manually by the authors.Results: The sympathetic and parasympathetic systems innervating the lower urinary tract may be disrupted due to resection of uterosacral and rectovaginal ligaments, the dorsal and lateral paracervix, the caudal part of the vesico-uterine ligaments, and the vagina. This supports the neurogenic etiology of early and late bladder dysfunction after radical surgery. Bladder disorders are also related to the extent of radical surgery. The neuropathopysiology of lower urinary tract symptoms after radical hysterectomy is not fully understood. Recent data have highlighted the role of urethral sphincter pressure in the etiology of postoperative incontinence. Various surgical approaches have been developed to preserve autonomic pelvic innervation.Conclusions: Nerve-sparing techniques appear to improve bladder function without compromising overall survival. Studies comparing the effects of nerve-sparing radical hysterectomy with standard surgery yielded encouraging results in respect of postoperative lower urinary tract function. Clinical trials with a long period of follow-up are required for better comprehension of the complex pathophysiology of bladder dysfunction after radical hysterectomy. (C) 2014 Wiley Periodicals, Inc.