Triangle Hysterectomy And Traditional Hysterectomy Was Full Of Bladder Function Of Influence

Background and objective:In recent years, Chinese women because of uterine fibroids, uterine fibroids, gland function such as disease benign lesions and the operation shows ascendant trend, and treatment of uterine disease hysterectomy is the most commonly used surgical methods. With the reproductive medicine and neuroendocrinology etc, more and more research progress of clinical studies show that: hysterectomy of ovarian function not only, and the influence of metabolism, bladder and pelvic function effect also nots allow to ignore.Urodynamic study has been used to evaluate the function of bladder, urethral and pelvic floor during both filling and voiding phrase. The exam is required to imitate the symptoms of daily activities in the controlled circumstances, through which urodynamic machine can determine the function of bladder and urethral and find out the possible reasons. Today, the role of routine urodynamic techniques is somewhat limited as the improvement of requirement on the disease diagnosis. Routine urodynamic technique can find out only the function changes, but not morphological changes. Ultrasound can clearly observe the position and mobolity of the bladder neck not only at rest and stress,and the deepth of the bladder wall.in the circumstances, through urodynamic machine can determine the function of bladder and urethral and find out the possible reasons. Today, the role of routine urodynamic ques is somewhat limited as the improvement of requirement on the disease diagnosis. Routine urodynamic technique can find out only the function changes, but not morphological changes. Ultrasound can clearly observe the the bladder neck not only at rest and stress,and the position and mobolity of of the bladder wall.In order to deepen our understanding of the different operation after hysterectomy under the function of the urethra, this study using ultrasound images of detrusor technology, October 2007 ~ 2008 October our due to the uterus and benign lesions of traditional hysterectomy and improved triangle hysterectomy postoperative recovery of bladder urethral function, in order to evaluate the clinical application of triangular hysterectomy for clinical value, provide proper operation.Materials and methods:1 Research object: select October 2007 to October 2008 in hebei people's hospital between benign gynecologic uterine surgery in hospital patients were randomly divided into two groups: 60, improved triangle hysterectomy for group of 30 cases of patients, uterine fibroids, uterine fibroids 20 cases of adenocarcinoma, 10 cases. Total resection of traditional hysterectomy compared with 30 cases. 18 cases of uterine fibroids, uterine fibroids 12 cases of adenocarcinoma. (two groups of patients age, professional generally no significant differences were retained bilateral accessories;). All of the patients were full of preoperative and postoperative follow-up b-sonography image urine dynamics. After surgery, the mean duration of follow-up was thirty and three days.2 We used DUET Logic urodynamicfrom device from Denmark. ICS ICS standards were carried out. The exam included uroflowmetry, cystometry, UPP and EMC Other parameters were max flow rate (MFR), post void residual (PVR),maximum cystometric capacity (MCC), Pdet at Qmax, bladder compliance(BC), and max urethral closure pressure (MUCP). Ultrasound examinations were carried out simultaneously with cystometry.3 DP-8800 ultrasound device (Mindary, China) was used in the exams. Electric convex array probe (65EC10EA, 6.5MHz) was applied in introital ultrasonograph. introital ultrasound examination was performed in a supine Position,Position of bladder neck and deepth of bladder wall were monitored when bladder filling was 200 ml at rest.4 SPSS 11.0 was used. Data was presented as mean±standard deviation. T test for paired- samples were used. a=0.05 was considered as significance.Results:1 After hysterectomy in patients with lower urinary tract symptoms usually characterized by frequent consciously, urgency, incontinence of urine and never-failing feeling, micturition waiting, etc. After five days, the abnormal symptoms than group, there were significant differences (P<0.05). A month after two groups of anomalies in number, but the two groups still statistically significant (P<0.05).2 After hysterectomy abnormal urine flow curve for the delay, curve flat peak: no, uninterrupted micturition peak curve, etc. Free urine flow rate determination result shows: preoperative two groups of free urine flow rate determination result was not statistically significant. After five days, the biggest urine flow rate, the average urine flow rate compared with the preoperative declined obviously, there was significant difference (P<0.05), and urine output is reduced, urine flow before time after micturition, residual urine volume increased, but compared with preoperative after treatment were statistically significant difference (P>0.05 ). Group's urine flow rate compared with the preoperative, statistically significant (P<0.05), average urine flow rate compared with the preoperative decline after micturition, urine output, compared with the preoperative residual urine volume, no statistically significant(P>0.05 ). Maximum urine flow rate, the control group is average urine flow rate significantly (P<0.05). A month after two groups have declined obviously abnormal results of two groups, but the biggest urine flow rate is still significant difference compared, (P<0.05). 3 After hysterectomy for bladder abnormal bladder detrusor muscle contraction: decreased bladder feel overly sensitive, etc, the results show that: the determination of bladder function preoperatively measuring results of two groups of bladder function was not statistically significant. After five days, the biggest forced urinous muscle pressure, bladder compliance with more than the preoperative and group, decreased obviously, statistically significant (P<0.05), the largest bladder capacity is not obviously change the preoperative and group, normal urinary bladder capacity means a preoperative and experimental decreased, but statistically significant differences between treatment after all, (P>0.05 ). After five days of experimental maximum pressure and bladder detrusor muscle compared with the preoperative compliance with significant difference (P<0.05 ), determination result was not statistically significant. A month after two groups have improved the bladder function, but the biggest group and group forced urinous muscle pressure measurement results are significant difference (P<0.05).4 Traditional hysterectomy functional urethral length is after surgery and triangle after hysterectomy compared to shorten, but no significant (P>0.05 ), the largest urethral pressure and maximal urethral closure pressure in surgery and no obvious changes (P>0.05 ).5 Two kinds of operation after hysterectomy, bladder wall thickness is preoperative no obvious difference (P>0.05 ). A period of perineum distance of the bladder neck to neck position, indicating that bladder surgery bladder neck didn't happen apparent meaninglessness, statistical analysis (P>0.05 ).Conclusions1. hysterectomy has adverse effects to urinary function.2. after hysterectomy lower urinary tract dysfunction of the urinary bladder detrusor dynamic characteristics for reducing muscle contractions, adaptability-give decline.3. although uterine complete with triangular hysterectomy was under the existence of urinary tract symptoms, and consciously, urine flow rate of different degree of dynamic change, but they still have significant difference, this study of triangular hysterectomy of bladder function complete than traditional hysterectomy.4. Free urine flow rate determination is simple and safe, easy, and invasive, can be used as a hysterectomy early detection of abnormal urine after screening method.