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Multi-institute survey on actual conditions of urologic management for severe bladder dysfunction after hysterectomy
Authors:Yoshimura Koji  Kamoto Toshiyuki  Okada Takuya  Kawakita Mutsushi  Ikeda Hiroki  Hayashi Tadashi  Yamamoto Masakazu  Kanamaru Hiroshi  Masui Kimihiko  Okuno Hiroshi  Aoyama Teruyoshi  Terai Akito  Higashi Shin  Nishio Yasunori  Ishitoya Satoshi  Okumura Kazuhiro  Nakajima Masakazu  Shichiri Yasumasa  Ueda Tomohiro  Oka Hiroya  Fukuzawa Shigeki  Okamura Yasuhisa  Nonomura Mitsuo  Okasho Kosuke  Taki Yoji  Onishi Hiroyuki  Moroi Seiji  Nishimura Kazuo  Ito Noriyuki  Soeda Asaki  Sasaki Miharu  Ito Masaaki  Ogura Keiji  Ogawa Osamu
Affiliation:Department of Urology, Kyoto University Graduate School of Medicine.
Abstract:We conducted a multi-institute survey on the conditions related to urologic management of severe voiding dysfunction after hysterectomy for uterine cancer with or without postoperative irradiation. Our first study population was a group of adult female patients currently managed by urologists, using clean intermittent catheterization (CIC). Of the 287 patients in this group, 99 (34%) had suffered from uterine cancer. Of these patients, 94 underwent hysterectomy for this disease; 44 and 30 were treated with or without postoperative radiation, respectively, while postoperative irradiation status was unknown for 20. Median follow-up after surgery was 21 (0.2-52) years and median interval from operation to the introduction of CIC was 4.0 (0-49) years. CIC tended to be introduced later for patients with postoperative radiation than those without it. Seventy-four patients, who required invasive urologic interventions other than CIC for voiding dysfunction after hysterectomy, are the second study population. Most of these (82%) had received postoperative irradiation. Continuous Foley catheter placement was the most frequent procedure. Long-term follow-up and urologic management for voiding dysfunction is required for patients undergoing hysterectomy.
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