Early postoperative bladder training in patients submitted to radical hysterectomy: is it still necessary? A randomized trial

Francesco Fanfani, Barbara Costantini, Floriana Mascilini, Giuseppe Vizzielli, Valerio Gallotta, Massimo Vigliotta, Emilio Piccione, Giovanni Scambia, Anna Fagotti

Research output: Contribution to journalArticle

Abstract

Objectives: To evaluate the role of bladder training during postoperative hospital stay in patients submitted to nerve-sparing radical hysterectomy, and to identify any clinical or surgical factor associated with postoperative bladder dysfunction. Design, setting, and participants: Parallel group randomized single institution trial, on gynaecologic malignancies patients conducted in Catholic University of Sacred Heart Rome, between April 2009 and November 2011. Randomization was on 1:1, using a block randomized computer-generated list. Interventions: Patients underwent Querleu-Morrow type B2 or C1 radical hysterectomy. After 2 days from surgery, patients were randomized to perform or not bladder training (scheduled clamping and unclamping of the trans-urethral catheter every three hours). Main outcome measures Necessity and duration of clean intermittent self catheterization. Results: Randomized participants were 111 women (bladder training arm n = 55; control arm n = 56). A total of 22 women (19.8 %) required clean intermittent self catheterization, equally distributed in the two arms. At univariate analysis, only the type of radical hysterectomy was significantly associated with need of clean intermittent self catheterization (type C1 vs. type B2; p = 0.013). At univariate analysis, duration of clean intermittent self-catheterization was not associated with age, BMI, type of hysterectomy and of neo-adjuvant treatment. Conclusions: Functional bladder disfunctions are the most common long-term complications following radical hysterectomy. Systematic postoperative bladder training following nerve-sparing radical hysterectomy does not influence the rate of urinary retention or re-admission for bladder catheterization.

Original languageEnglish
Pages (from-to)883-888
Number of pages6
JournalArchives of Gynecology and Obstetrics
Volume291
Issue number4
DOIs
Publication statusPublished - 2015

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Keywords

  • Bladder training
  • Clean intermittent self catheterization
  • Gynaecologic cancer
  • Radical hysterectomy

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Medicine(all)

Cite this

Fanfani, F., Costantini, B., Mascilini, F., Vizzielli, G., Gallotta, V., Vigliotta, M., Piccione, E., Scambia, G., & Fagotti, A. (2015). Early postoperative bladder training in patients submitted to radical hysterectomy: is it still necessary? A randomized trial. Archives of Gynecology and Obstetrics, 291(4), 883-888. https://doi.org/10.1007/s00404-014-3500-5