Urodynamic Study In Lower Urinary Tract Function After Different Piver Types Hysterectomy

Objective1. To analyze the urodynamic data and to assess the functional alterations of lower urinary tract in the patients pre- and post operation of different piver types of hysterectomy, to explore the mechanism, main factors and tendency of lower urinary tract dysfunction, to guide the classification of diagnosis and treatment of lower urinary tract dysfunction, and hence to arrive the aim of specific early intervention;2. To evaluate the value of clinical application of urodynamic examination in patients with lower urinary tract dysfunction post operation of Typeâ…¢hysterectomy.Method1.58 women who underwent different types of hysterectomy without complications and other diseases, were divided into three groups according to the type of hysterectomy: 19 cases with Type I hysterectomy group,11 cases with Typeâ…¡hysterectomy group and 28 cases with Type III hysterectomy group;2. Urodynamic examination was performed in the patients pre-operation and post surgery at 12 to 14 days. The examination will be carried out again in patients with typeâ…¢hysterectomy post-operation for 3 to 6 months;3. According to the urodynamic data, analyze the variation tendency of urodynamic parameters of a patient pre-operation, followed up in short- and medium-term post-operation, and then compare the short-term difference of urodynamic parameters in different groups of patients post-operation.Results1. The short-term post void residual (PVR) and maximal vesical pressure (Pvesmax) of Type I hysterectomy were increased, bladder compliance (BC) was decreased compared with pre-operatives (P<0.05);2. The short-term PVR and Pvesmax of typeâ…¡hysterectomy were increased, voided volume (VV), detrusor pressure (Pdet), BC, maximum urethral pressure (MUP) and maximum urethral closure pressure (MUCP) were decreased compared with which pre-operatives (P<0.05) 3. The short-term PVR, flow time(FT), first desire to void volume (FDV) and Pvesmax were increased in group of typeâ…¢hysterectomy; max flow rate (Qmax), average flow rate (Qave), VV, maximum cystometric capacity (MCC), BC, Pdet, MUP and MUCP were significantly decreased compared with preoperative (P<0.05); PVR, FT, FDV and Pvesmax in mid-term post-hysterectomy were increased, and Qmax, Pdet, BC, MUP and MUCP were decreased compared with preoperative (P<0.05); Qmax, Qave, VV, MCC, BC and Pdet in mid-term post-hysterectomy increased significantly, PVR and Pvesmax were decreased compared with short-term post-operative (P<0.05);4.2Qave, VV, BC, Pdet, MUP and MUCP in short-term of Typeâ…¡post-hysterectomy, were decreased, and PVR and Pvesmax were increased compared with that of Typeâ… post-hysterectomy(P<0.05); Qmax, Qave, Pdet in short-term of Typeâ…¢hysterectomy were decreased, FT, FDV and Pvesmax were increased compared with that of typeâ… and typeâ…¡post-hysterectomy(P<0.05);VV, BC, MUP and MUCP were decreased, PVR was increased compared with that of typeâ… post-hysterectomy(P<0.05).Conclusion1. Lower urinary tract function in patients with Typeâ… hysterectomy is not obvious abnormal;2. Part of patients with Typeâ…¡hysterectomy appear mild alterations of lower urinary tract dysfunction, including bladder storage, voiding and urinary continence function;3. Most of patients with Typeâ…¢hysterectomy show severe lower urinary tract dysfunction in short-term post operation, i.e.bladder storage dysfunction due to sharply decreasing of bladder compliance and abnormal increasing of bladder pressure, voiding function decline causing by without detrusor contractility, and low urinary continence by decreasing of urethral closure pressure, the two former can partial recovr in the mid-term.4. Urodynamic examination is helpful in lower urinary tract dysfunction for early assessment and classified diagnosis in patients with Typeâ…¢hysterectomy.