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Abstract
Introduction/Background RECENT STUDIES HAVE SHOWN THAT PATIENTS UNDERGOING VOIDING TRIAL BY BLADDER RETROFILLING ARE DISCHARGED FROM THE HOSPITAL FASTER . BUT NONE, SO FAR HAVE INCORPORATED THIS TECHNIQUE FOR NERVE SPARING RADICAL HYSTERECTOMY(NSRH) .
THIS NOVEL BLADDER RETROFILL METHOD CAN BE A PRACTICE CHANGING APPROACH FURTHER REDUCING THE HOSPITAL STAY AND THUS BE A NEW KID ON THE BLOCK IN THE ERA OF ERAS FOR RADICAL SURGERIES.
Methodology WE CONDUCTED A PILOT STUDY TO
I) COMPARE THE NOVEL RETROGRADE BLADDER FILLING TECHNIQUE WITH CONVENTIONAL BLADDER TRAINING FOR VOIDING TRIAL
II) INVESTIGATE THE BLADDER FUNCTION RECOVERY AND QUALITY OF LIFE (QOL) IN PATIENTS UNDERGOING NERVE-SPARING RADICAL HYSTERECTOMY (NSRH)
STUDY PERIOD: JAN 2019 -DEC 2021
TYPE: PROSPECTIVE INCLUSION CRITERIA: PATIENTS WHO UNDERWENT NSRH PATIENTS WITH NORMAL PREOPERATIVE BLADDER FILLING AND VOIDING FUNCTION .
EXCLUSION CRITERIA: DISTANT METASTASIS
AS PER THE CONVENTIONAL CLAMPING METHOD OF VOIDING TRIAL FOLEYS WAS REMOVED ON 7 TH DAY AFTER INTERMITTENT CLAMPING ON DAY 5 AND 6.
WHILE IN THE RETROFILLING APPROACH FOLEYS WAS REMOVED ON POD 5 .BLADDER FUNCTION RECOVERY WAS COMPARED IN THESE TWO GROUPS IN TERMS OF PREVOID VOLUME AND POST VOID RESIDUAL VOLUMES ON DAY 5, DAY 14 AND 4 TH MONTH FOLLOW UP .
Bladder function assessment: clamping v/s retrograde technique
Kaplan meier curve for dration of hospital stay among 2 groups
Intraoperative images of nerve sparing radical hysterectomy
Results THERE IS NO SIGNIFICANT DIFFERENCE BETWEEN BLADDER FUNCTION RECOVERY USING THE CONVENTIONAL CLAMPING METHOD AND THE RETROFILLING APPROACH.
Conclusion USING THE RETROFILLING APPROACH PATIENT CAN BE DISCHARGED ON POST OPERATIVE DAY 5, FURTHER REDUCING HOSPITAL STAY IN NSRH CASES.
ALSO IN RETROGRADE FILLING APPROACH, PREVOID VOLUME COULD BE MEASURED SIMULATANEOUSLY WITHOUT NEEDING USG FOR SAME .
OURS IS THE FIRST EVER STUDY TO HAVE INCORPORATED THIS TECHNIQUE FOR NSRH.