Risk factors for persistent XXXX after radical hysterectomy.

@entity1 @entity3041 @entity1494 @entity1161
INTRODUCTION: Bladder compliance deteriorates immediately after radical hysterectomy (RH), and @entity1494 causes upper urinary tract dysfunctions such as progressive @entity3041 . The aims of this study were to clarify risk factors for persistent @entity1494 after RH and to propose a postsurgical management protocol for improved recovery of bladder function. METHODS: A total of 113 consecutive @entity1 who underwent RH with the intention to preserve the pelvic autonomic nerve system were included in this prospective study. Urodynamic studies were performed according to a planned schedule: presurgery and 1, 3, 6, and 12 months after surgery. Autonomic nerves were preserved at least unilaterally in 95 (84.1%) of the 113 @entity1 , but this was not possible in the remaining 18 @entity1 (15.9%). Postoperative adjuvant @entity1161 ( @entity1161 ) was performed in 14 @entity1 . The relationships between bladder compliance and various clinical factors were investigated using logistic regression analysis. Covariates included age, nerve-sparing procedure, adjuvant @entity1161 , and maximum abdominal pressure during the voiding phase. Bladder compliance at 12 months after surgery was used as the dependent variable. RESULTS: Radical hysterectomy with a non-nerve-sparing procedure (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.1-11.0), adjuvant @entity1161 (OR, 10.3; 95% CI, 2.5-43.5), and voiding with abdominal pressure at 3 months after surgery (OR, 2.9; 95% CI, 1.1-7.2) were risk factors for persistent @entity1494 . CONCLUSIONS: A nerve-sparing procedure and prohibition of voiding with abdominal strain during the acute and subacute phases after RH resulted in improved recovery of bladder compliance. @entity1161 should be avoided in @entity1 who undergo nerve-sparing RH if an alternative postoperative strategy is possible.
