The causes of lower urinary tract dysfunction in patients with invasive cervical cancer after radical hysterectomy (literature review)

Surgery of invasive cervical cancer is associated with urologic complications. The main urological complications after radical hysterectomy are various forms of the bladder dysfunction: overactive bladder, detrusor areflexia and incontinence. The frequency of the bladder dysfunction has different indicators: from 0.8% to 40.8% of the observations. Some authors have reported that the bladder dysfunction reaches 70,0-85,0% of cases. The contradictory results of the research may be explained by use the different methods of bladder evaluation function, lack of population data, adjuvant radiation therapy, the technical facilities of surgical teams and complexity of operation. Spontaneous recovery of bladder function can be 6-12 months after the radical hysterectomy. The frequency of the long-term bladder dysfunction in patients who underwent operation is approximately 16.0% of cases. Thus, detrusor areflexia observed in 2,0-85,7% of patients after radical hysterectomy and overactive bladder seen in 10,221,0% of cases following surgery. The frequency of involuntary urinary leakage at 6 weeks after surgery is 48,0-53,0%, and decreased to 30.0% at 3 months after operation. At the same time 15.0% of women go to the doctor about urinary incontinence episodes at one year after surgery. Knowledge of neuroanatomy and physiology of the urinary bladder, introduction of functional-sparing techniques in the surgical treatment of cervical cancer stage IB-IIA, can reduce the incidence of urinary tract morbidity.