Purpose: To clarify which patients need careful neurourological management\nafter abdominal radical hysterectomy (RH) by investigating the effects of adjuvant\nradiotherapy and reversibility of neurogenic bladder (NB) on the storage\nfunction as well as the effects of urethral resistance on the emptying\nfunction. Methods: Data from sixty-two patients referred to our NB clinic after\nRH were retrospectively reviewed. Findings of urodynamic studies performed\nat 3 (UDS-1) and 12 (UDS-2) months after treatment were compared,\nand logistic analysis was used to calculate the odds ratio (OR) of the effects of\nradiotherapy and irreversible NB on decreased bladder capacity and decreased\ncompliance. Irreversible NB was defined as the need for clean intermittent\ncatheterization at the last follow-up. Results: At the median follow-up period\nof 41 months, 60% of the patients continued to require clean intermittent catheterization.\nOf patients with irreversible NB and radiotherapy, 80% had decreased\nbladder capacity and decreased compliance at UDS-2. For decreased\nbladder capacity and decreased compliance, ORs of adjuvant radiotherapy at\nUDS-2 were 38.42 (p < 0.001) and 7.46 (p = 0.001), respectively, while ORs of\nirreversible NB were 1.64 (p = 0.527) and 3.42 (p = 0.062), respectively. Detrusor\ncontraction could be demonstrated in only 15% and 45% at UDS-1 and\nUDS-2, respectively. However, regardless of improvement in detrusor con-tractility, urodynamic studies revealed a high urethral resistance. Conclusions:\nCareful neurourological follow-up after RH is mandatory for patients\nwho undergo adjuvant radiotherapy and have irreversible NB with impaired\nurethral relaxation.
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