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425 Urodynamic study before and after radical hysterectomy, a single center study
  1. Alaa Shaaban Abdellateif Hemeda,
  2. Engy Mohamed Taher el-Yatfty,
  3. Ahmed Mohamed Samy El-Agwany and
  4. Mahmoud El-Sayed Meleis
  1. Elshatby Maternity University Hospital, Alexandria, Egypt


Introduction/Background Radical hysterectomy has an excellent oncological outcome in cases of cervical or endometrial cancer, but its safety profile is questionable. Bladder dysfunction is among the most common complications of radical hysterectomy. Goal is to detect any urodynamic changes in female patients after radical hysterectomy

Methodology A RCT was conducted on 42 cases divided into two groups: Nerve sparing (7 cases) and non-nerve sparing group (35 cases) at Elshatby University Hospital, Alexandria, Egypt. Cases had been subjected to urodynamic evaluation at 3 time points: before undergoing radical hysterectomy, 2 weeks and 12 weeks post-operatively. Urodynamic testing consists of uroflowmetry, filling cystometry, pressure-flow study and valsalva leak point pressure (VLPP) to detect the most commonly reported symptoms after radical hysterectomy.

Results Two weeks post-operatively, no urodynamic abnormality was detected in any individual in the nerve-sparing group (100% normal) compared to only 5.7% in the non-nerve sparing group (P-value< 0.001) .The urodynamic changes observed were 37.1% detrusor hyperactivity, 31.4% stress urinary incontinence and 25.7% voiding dysfunction. The proportion of individuals with no urodynamic abnormalities increased from 5.7% (two weeks post-operatively) to 74.3% (12 weeks post-operatively) (P-value 0.51).

Conclusion Comparing the rate of different post-operative complications following the nerve-sparing technique and the conventional non-nerve sparing technique shows significant superiority of the nerve-sparing technique in terms of urological safety. Nerve-sparing radical hysterectomy is associated with faster recovery of normal urinary functions compared to conventional approach. Post-operative urodynamic changes will most likely vanish within months. Patients still suffering from urodynamic abnormalities three months after the surgery are likely to have an underlying nerve cut injury. On the other hand, patients with detectable urodynamic abnormalities two weeks post-operatively who managed to heal before the second urodynamic evaluation (12 weeks post-operatively) are more likely to have suffered only a nerve concussion.

Disclosures Nothing to disclose.

Abstract 425 Table 1

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