GENITOURINARY DISORDERS IN WOMEN WHO UNDERWENT RADICAL UTERINE SURGERY
DOI:
https://doi.org/10.11603/24116-4944.2020.2.11884Keywords:
uterine fibroids, hysterectomy, dysuric manifestations, sexual dysfunctionAbstract
The aim of the study – to determine early diagnostic predictors of genitourinary syndrome based on the assessment of the frequency and structure of urogenital dysfunction in the remote period after hysterectomy performed for uterine fibroids.
Materials and Methods. We observed for 5 years 100 women aged 40 to 50 years who underwent radical surgery for uterine fibroids, where 40 women underwent hysterectomy with transabdominal access, 30 patients – classic transvaginal hysterectomy, and 30 – transvaginal hysterectomy associated with laparoscopic access.
Results and Discussion. Of the 58 patients with urological disorders, 44.8 % were diagnosed with dysuric manifestations in the case of transabdominal hysterectomy, 27.6 % in the case of transvaginal hysterectomy, and 10.3 % in the case of transvaginal hysterectomy associated with laparoscopic access. It should be noted that the proportion of cysturethritis in the case of hysterectomy increased by the fifth year after surgery in 3.0 times – from 7.0 % to 21.0 %, the most significant in patients after abdominal hysterectomy. Urological manifestations such as pollakiuria, incomplete bladder emptying, stress incontinence and imperative urinary incontinence showed the highest severity also in patients after transabdominal and classic transvaginal hysterectomy with a history of surgical treatment of 5 years or more, the lowest degree in the case of LAVH. Similarly, the lowest scores for all domains of the sexual dysfunction questionnaire were found in the group with hysterectomy with transabdominal and classic transvaginal access, where underestimated sexual function was diagnosed compared to the healthy population (<27 points in 22.5 % and in 36.7 % of cases, respectively).
Conclusions. Thus, every third patient before the fifth year of monitoring after hysterectomy noted pelvic floor failure and signs of cysto-rectocele I-II degree, pelvic floor relaxation syndrome, and the severity of genitourinary disorders directly depended on surgical techniques, age when treatment and degree of hypoestrogenism.
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