Skip to main content
SpringerLink
Log in

Stress urinary incontinence following radical hysterectomy with and without radiation therapy: Surgical results in 13 patients

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Only a few articles have reported clinical experience of treating patients with stress urinary incontinence following radical hysterectomy and postoperative irradiation. These cases are generally characterized by detrusor areflexia, small bladder capacity, and low bladder compliance. During the past 5 years, 13 such patients were operated upon, including 6 patients without irradiation. Of these 8 had the Stamey procedure, 3 had a vaginal wall sling, and 2 had a pubovaginal sling. The success rate was 71% for the group with irradiation and 100% for the group without irradiation, while the overall success rate was 85%. Surgery significantly improved two anatomic parameters in a chain cystourethrogram: the posterior urethrovesical angle and the conjugata incontinentia. Surgical indications relevant to successful outcome are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. McGuire EJ, Lytton B. Pubovaginal sling procedure for stress incontinence.J Urol 1978; 119:82–84

    PubMed  Google Scholar 

  2. Woodside JR, Borden TA. Pubovaginal sling procedure for the management of urinary incontinence in a myelodysplastic girl.J Urol 1982; 127:744–746

    PubMed  Google Scholar 

  3. Woodside JR. Suprapubic endscopic vesical neck suspension (Stamey procedure) for control of urinary incontinence in a woman following cauda equina injury.J Urol 1984; 132:940–942

    PubMed  Google Scholar 

  4. Lawrence WT, Thomas DG. The Stamey bladder neck suspension operation for stress incontinence and neurovesical dysfunction.Br J Urol 1987; 59:305–310

    PubMed  Google Scholar 

  5. Kato K, Kondo A, Takita T, et al. Incontinence in female neurogenic bladders. Resolution by endoscopic bladder neck suspension.Br J Urol 1987; 59:523–525

    PubMed  Google Scholar 

  6. Thornton WN. Late urinary system complications following radical hysterectomy for carcinoma of the cervix.Am J Obstet Gynecol 1954; 67:867–882

    PubMed  Google Scholar 

  7. Green TH, Meigs JV, Ulfelder H, et al. Urologic complications of radical Wertheim hysterectomy: incidence, etiology, management and prevention.Obstet Gynecol 1962; 20:293–312

    PubMed  Google Scholar 

  8. Abrams P, Blaivas JG, Stanton SL, and Anderson JT. Standardisation of terminology of lower urinary tract function.Neurourol Urodynam 1988; 7:403–427

    Google Scholar 

  9. Kondo A, Kato K, Gotoh M, et al. Quantifying thread tension is of clinical use in Stamey bladder neck suspension: analysis of clinical parameters.J Urol 1989; 141:38–42

    PubMed  Google Scholar 

  10. Raz S, Siegel AL, Short GL, et al. Vaginal wall sling.U Urol 1989; 141:43–46

    Google Scholar 

  11. McGuire EJ, Wang C, Usitalo H, et al. Modified pubovaginal sling in girls with myelodysplasia.J Urol 1986; 135:94–96

    PubMed  Google Scholar 

  12. Fishman IJ, Shabsigh R, Kaplen AL. Lower urinary tract dysfunction after radical hysterectomy for carcinoma of cervix.Urology 1986; 28:462–468

    Article  PubMed  Google Scholar 

  13. Bostofte E, Serup J. Urological complicatins of Okabayashi's operation for cervical cancer.Acta Obstet Gynecol Scand 1981; 60:39–42

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Nagoya University School of Medicine, 65 Tsuruma, 466, Showa, Nagoya, Japan

    S. Hasegawa, A. Kondo, K. Kato, M. Saito & K. Miyake

Authors
  1. S. Hasegawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Kondo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. Kato
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. Miyake
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Supported partly be a research grant for aging from the Japanese Ministry of Health and Welfare.

Editorial Comment: Little is known regarding the therapy of genuine stress incontinence following radical hysterectomy, especially when associated with radiation therapy. The surgeon is faced with potentially severely altered urethrovesical function due to the decentralization of the lower urinary tract secondary to the radical surgery. Non-compliant low capacity bladders make therapy of stress incontinence difficult. When radiation therapy is added marked alterations in tissue plasticity and blood supply result. The combination of all these factors complicate the medical and surgical therapy of incontience, and frequently the surgeon decides not to operate because of the increased possibility of failure. Although the numbers are small this paper demonstrates that good success rates for surgical therapy of genuine stress incontinence is possible when the proper surgical procedure is chosen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hasegawa, S., Kondo, A., Kato, K. et al. Stress urinary incontinence following radical hysterectomy with and without radiation therapy: Surgical results in 13 patients. Int Urogynecol J 2, 127–131 (1991). https://doi.org/10.1007/BF01997421

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01997421

Keywords

Search

Navigation