Archivos Españoles de Urología

The Impact of Early Postoperative Pelvic Floor Muscle Exercise on Urinary Retention and Urodynamics after Radical Hysterectomy for Cervical Cancer

Radical hysterectomy effectively treats cervical cancer and extends patient survival but may cause postoperative urinary retention. This study examined the effect of early pelvic floor muscle exercise after radical hysterectomy for cervical cancer on reducing urinary retention and influencing urodynamic aspects. The study focused on patients who underwent radical hysterectomy for cervical cancer at the First Affiliated Hospital of Bengbu Medical University between January 2021 and December 2024. Clinical data, urinary retention, catheter replacement, dysuria, residual bladder urine volume, self-perception and comfort levels were compared. Logistic regression analysed the significance of early exercises on urinary retention risk. A total of 202 patients with cervical cancer after radical operation were included, with 92 in the intervention group and 110 in the control group. After propensity score matching, 83 patients with early postoperative pelvic floor muscle exercise were in the intervention group, and 83 clinically-matched non-exercising patients were in the control group. We found no significant differences in general characteristics ( Early postoperative pelvic floor muscle exercise can enhance bladder function, reduce urinary retention risk and improve patient comfort after radical hysterectomy for cervical cancer.

Assessment of the Incidence and Risk Factors of Stress Urinary Incontinence in Women after Cervical Cancer Surgery: A Single-Centre Retrospective Study

Stress urinary incontinence (SUI) is a common postoperative complication that significantly affects the quality of life in women who have undergone radical hysterectomy for cervical cancer. This study evaluates the incidence and risk factors associated with SUI in women after cervical cancer surgery. This case-control study included women diagnosed with cervical cancer who underwent radical hysterectomy at our hospital between May 2020 and May 2023. Participants were divided into two groups based on the presence of postoperative SUI, namely the SUI group and the SUI-free group. Inclusion criteria required the absence of preoperative urinary incontinence and stable vital signs. Data were collected on demographic characteristics, tumour histology and staging, urodynamic parameters, and intraoperative and postoperative factors. Ninety-seven patients with cervical cancer who underwent radical hysterectomy were divided into two groups: The SUI group (n = 27) and the SUI-free group (n = 70), with an SUI incidence of 27.8% in the study population. Significant differences between the SUI and SUI-free groups were observed in menopausal status ( SUI is a significant postoperative complication in women undergoing cervical cancer surgery. Menopause, chronic constipation, tumour diameter, Qmax, and surgery duration were independent risk factors.

Effect of Pelvic Floor Function Exercises Based on the ERAS Concept on Lower Urinary Tract Symptoms after Radical Hysterectomy for Cervical Cancer: A Retrospective Cohort Study

This study aimed to analyse the effect of pelvic floor function exercises based on the enhanced recovery after surgery (ERAS) concept on lower urinary tract symptoms after radical hysterectomy for cervical cancer. The retrospective study was conducted using clinical data of patients admitted to our hospital from January 2021 to December 2022 and underwent radical hysterectomy for cervical cancer. In accordance with the nursing method, the patients were divided into the routine group (conventional care) and the ERAS pelvic floor function exercise group, for which ERAS concept-based pelvic floor function exercises were carried out on the basis of the former group. The confounders between the two groups were matched by propensity score, and the scores of urination, pelvic floor muscle strength, lower urinary tract symptoms and quality of life (QoL) were compared between the two groups after matching. A total of 180 patients were included in the study, of whom 60 patients were identified after propensity score matching, consisting of 30 patients each in the ERAS and routine groups. The baseline characteristics of the two groups were balanced, and the difference was not statistically significant ( Pelvic floor function exercises based on the ERAS concept can relieve lower urinary tract symptoms, accelerate urination and improve pelvic floor muscle strength and QoL after radical hysterectomy for cervical cancer.

Family Resilience and Its Influencing Factors in Patients with Stress Urinary Incontinence after Cervical Cancer Surgery: A Retrospective Study

This study aimed to analyse the family resilience of patients with stress urinary incontinence (SUI) after cervical cancer surgery and its influencing factors. Patients with cervical cancer postoperative SUI admitted to our hospital from May 2020, to May 2023, were retrospectively selected. They were divided into low-resilience group and high-resilience group in accordance with the Family Resilience Questionnaire (FaREQ). The general demographic data of the two groups were statistically analysed, and correlation and logistic regression analyses were performed. The FaREQ score of 222 patients was (93.61 ± 8.45). Amongst these patients, 21.62% scored less than 84 points, and 78.38% scored more than 84 points. Significant differences were found in the educational level, indwelling catheter time, family monthly income, religious belief, hope index, psychological resilience, family function and social support between the two groups ( The level of family resilience of patients with SUI after cervical cancer surgery is low. Many factors, such as family monthly income and religious belief, affect the level of resilience. Therefore, corresponding measures could be formulated in advance to improve the level of family resilience of such patients.

Pelvic Floor Functional Exercise Improves Lower Urinary Tract Symptoms after Uterine Fibroid Surgery

This study aims to determine the effect of pelvic floor function exercise on the improvement of lower urinary tract symptoms in patients with uterine fibroid surgery. The clinical data of 188 patients who underwent uterine fibroid surgery in our hospital from February 2020 to December 2022 were retrospectively analysed. The patients were divided into a control group and an observation group according to the nursing methods recorded in the data. The observation group received targeted nursing combined with pelvic floor function exercise based on routine intervention. General demographic data, disease and surgery-related characteristics of the patients were collected. Propensity score matching was used to balance the baseline data of the two groups. Lower urinary tract symptoms, pelvic floor function, pelvic floor muscle strength and quality of life were compared between the two groups after matching. A total of 130 patients were included in the two groups, and their baseline data were not statistically significant. At 3 months after the operation, the total incidence of lower urinary tract symptoms in the observation group (10.77%) was lower than that in the control group (30.77%, Targeted nursing combined with pelvic floor function exercise for patients with uterine fibroids surgery can prevent the occurrence of lower urinary tract symptoms and improve the pelvic floor function, pelvic floor muscle strength and quality of life of patients and is thus worthy of promotion.

3D Laparoscopic Ureterolysis for Retroperitoneal Fibrosis Secondary to Radical Hysterectomy and Radiation Treatment for Cervical Cancer: Results from the Oncological Institute, Cluj Napoca

Ureterolysis represents the surgical treatment for retroperitoneal fibrosis. The aim of the study was to review the outcomes of patients who had undergone radical hysterectomy and radiotherapy for cervical cancer that later developed retroperitoneal fibrosis, for whom 3D laparoscopic ureterolysis was performed in our department and to review current published studies. We present a series of cases consisting of 6 patients with secondary retroperitoneal fibrosis. In all cases, the intervention was performed by the same surgeon from the Oncological Institute "Prof. Dr. Ion Chiricuță" Cluj-Napoca, Romania. We carried out a literature review, searching in the PubMed and MEDLINE studies published between 2000 and 2021 relevant to the matter and a total of 12 papers were selected. We reviewed the functional outcomes of patients that underwent minimally invasive ureterolysis. 3D laparoscopic ureterolysis was performed in 6 patients. Mean operative time was 166 minutes and mean blood loss was 203 mL. No surgery required conversion. Five patients showed good functional results after ureteral stent removal. In one case, the patient developed acute pyelonephritis and the ureteral stents were kept. Laparoscopic ureterolysis for retroperitoneal fibrosis secondary to operated and radiation-treated cervical cancer represents one of the most complex and challenging surgeries in the urological field. From personal experience we conclude that in oncological centers with vast experience in laparoscopy this minimally invasive approach is feasible and safe. Published data, even though scarce, strengthens our results and the need for this surgery in patients with retroperitoneal fibrosis with urological impact. The laparoscopic approach comes with good functional results and with the advantages of faster post-operative recovery comparing to open surgery and comparable results with the precision and dexterity offered by the robotic approach, but with lower economic burden.

Aetiology and Prognostic Significance of Postoperative Urinary Tract Infections in Patients with Cervical Cancer

This study aimed to investigate the risk factors for urinary tract infections (UTIs) in patients with cervical cancer (CC) following radical surgery, and analyse the etiological distribution and prognostic implications of these infections. A retrospective analysis was conducted on the clinical data of 168 patients with CC who underwent radical surgery at our hospital between January 2021 and December 2023. Postoperative UTI incidence and associated risk factors were analysed. Postoperative urine samples were collected under sterile conditions for pathogen culture to analyse pathogen distribution. Patients were classified into poor and good prognosis groups based on their health status within one month of treatment. The relationship between pathogen distribution and prognosis in patients with CC and postoperative UTIs was analysed. The incidence of postoperative UTIs was 35.12% (59 cases). Among these patients, 84 pathogen strains were detected in urine samples, including 54 of gram-negative bacteria, 26 of gram-positive bacteria, and four of fungi. The single-factor analysis identified age, diabetic status, menopausal status, tumour diameter, surgical duration, intraoperative blood loss volume, duration of ureteral catheterisation, and postoperative urinary retention as potential risk factors. The multifactorial analysis confirmed age, diabetic status, operation duration, intraoperative blood loss volume, duration of ureteral catheterisation, and postoperative urinary retention as independent risk factors. The distribution of UTIs in patients with CC post-radical surgery are primarily caused by gram-negative bacteria, mainly

Role of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Cases of Peritoneal Carcinomatosis that Require Nephrectomy