TY - JOUR
T1 - Early postoperative bladder training in patients submitted to radical hysterectomy
T2 - is it still necessary? A randomized trial
AU - Fanfani, Francesco
AU - Costantini, Barbara
AU - Mascilini, Floriana
AU - Vizzielli, Giuseppe
AU - Gallotta, Valerio
AU - Vigliotta, Massimo
AU - Piccione, Emilio
AU - Scambia, Giovanni
AU - Fagotti, Anna
PY - 2015
Y1 - 2015
N2 - 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.
AB - 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.
KW - Bladder training
KW - Clean intermittent self catheterization
KW - Gynaecologic cancer
KW - Radical hysterectomy
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U2 - 10.1007/s00404-014-3500-5
DO - 10.1007/s00404-014-3500-5
M3 - Article
C2 - 25273982
AN - SCOPUS:84925506919
VL - 291
SP - 883
EP - 888
JO - Archives of Gynecology
JF - Archives of Gynecology
SN - 0170-9925
IS - 4
ER -