Abstract
Radical pelvic surgery is commonly utilized for the treatment of pelvic malignancy. Radical hysterectomy, radical prostatectomy, and abdominoperineal resection are among the most commonly utilized pelvic operations for the management of malignancy. Despite the development of nerve-sparing techniques and the use of robotic surgery, urinary symptoms often develop after these operations in the immediate postoperative period, but urinary dysfunction may also persist in the long term. In this chapter, we review the anatomy and pathophysiology that accounts for bladder dysfunction after pelvic surgery, in addition to both the early and late symptoms and urodynamic findings after radical pelvic surgery.
Contributors: Paul D. Slocum, Jr.
Similar content being viewed by others
References
A. Bill-Axelson, L. Holmberg, F. Filén, M. Ruutu, H. Garmo, C. Busch, et al., Radical prostatectomy versus watchful waiting in localized prostate cancer: The Scandinavian prostate cancer group-4 randomized trial. J. Natl. Cancer Inst. 100(16), 1144–1154 (2008)
L. Holmberg, A. Bill-Axelson, F. Helgesen, J.O. Salo, P. Folmerz, M. Häggman, et al., A randomized trial comparing radical prostatectomy with watchful waiting in early prostate cancer. N. Engl. J. Med. 347(11), 781–789 (2002)
P.C. Walsh, P.J. Donker, Impotence following radical prostatectomy: Insight into etiology and prevention. J. Urol. 128(3), 492–497 (1982)
T.F. Lue, S.J. Zeineh, R.A. Schmidt, E.A. Tanagho, Neuroanatomy of penile erection: Its relevance to iatrogenic impotence. J. Urol. 131(2), 273–280 (1984)
H. Lepor, M. Gregerman, R. Crosby, F.K. Mostofi, P.C. Walsh, Precise localization of the autonomic nerves from the pelvic plexus to the corpora cavernosa: A detailed anatomical study of the adult male pelvis. J. Urol. 133(2), 207–212 (1985)
P.N. Schlegel, P.C. Walsh, Neuroanatomical approach to radical cystoprostatectomy with preservation of sexual function. J. Urol. 138(6), 1402–1406 (1987)
P.C. Walsh, The discovery of the cavernous nerves and development of nerve sparing radical retropubic prostatectomy. J. Urol. 177(5), 1632–1635 (2007)
F. Plotti, R. Angioli, M.A. Zullo, M. Sansone, T. Altavilla, E. Antonelli, et al., Update on urodynamic bladder dysfunctions after radical hysterectomy for cervical cancer. Crit. Rev. Oncol. Hematol. 80(2), 323–329 (2011)
R.J. Scotti, A. Bergman, N.N. Bhatia, D.R. Ostergard, Urodynamic changes in urethrovesical function after radical hysterectomy. Obstet. Gynecol. 68(1), 111–120 (1986)
L. Rob, M. Halaska, H. Robova, Nerve-sparing and individually tailored surgery for cervical cancer. Lancet Oncol. 11(3), 292–301 (2010)
T. Bessede, P. Sooriakumaran, A. Takenaka, A. Tewari, Neural supply of the male urethral sphincter: Comprehensive anatomical review and implications for continence recovery after radical prostatectomy. World J. Urol. 35(4), 549–565 (2017)
J. Low, G. Mauger, J. Carmichael, The effect of Wertheim hysterectomy upon bladder and urethral function. Am. J. Obstet. Gynecol. 139(7), 826–830 (1981)
J.P. Forney, The effect of radical hysterectomy on bladder physiology. Am. J. Obstet. Gynecol. 138(4), 374–382 (1980)
G. Ralph, R. Winter, L. Michelitsch, K. Tamussino, Radicality of parametrial resection and dysfunction of the lower urinary tract after radical hysterectomy. Eur. J. Gynaecol. Oncol. 12(1), 27–30 (1991)
T. Manchana, C. Prasartsakulchai, A. Santingamkun, Long-term lower urinary tract dysfunction after radical hysterectomy in patients with early postoperative voiding dysfunction. Int. Urogynecol. J. 21(1), 95–101 (2010)
E.J. McGuire, Clinical evaluation & treatment of neurogenic vesical dysfunction. (1984)
A. Mundy, Pelvic plexus injury. In: Urodynamics: Principles, practice, and application (Churchill Livingstone, Edinburgh, 1984), pp. 273–277
J. Blaivas, M. Chancellor, Cauda equina and pelvic plexus injury. Practical Neurourology: Genitourinary complications in neurologic diseases (Butterworth-Heinemann, Boston, 1995), pp. 155–114
K.M. Kan, A.L. Tin, G.L. Stearns, J.A. Eastham, D.D. Sjoberg, J.S. Sandhu, Urinary storage symptoms are common after radical prostatectomy: Incidence, natural history and predictors. J. Urol. (2021). https://doi.org/10.1097/JU.0000000000002312
G.-D. Chen, L.-Y. Lin, P.-H. Wang, H.-S. Lee, Urinary tract dysfunction after radical hysterectomy for cervical cancer. Gynecol. Oncol. 85(2), 292–297 (2002)
T.-Y. Chuang, K.-J. Yu, I.-W. Penn, Y.-C. Chang, P.-H. Lin, Y.-A. Tsai, Neurourological changes before and after radical hysterectomy in patients with cervical cancer. Acta Obstet. Gynecol. Scand. 82(10), 954–959 (2003)
Y. Kadono, S. Ueno, D. Iwamoto, Y. Takezawa, T. Nohara, K. Izumi, et al., Chronological urodynamic evaluation of changing bladder and urethral functions after robot-assisted radical prostatectomy. Urology 85(6), 1441–1447 (2015)
P. Benedetti-Panici, M.A. Zullo, F. Plotti, N. Manci, L. Muzii, R. Angioli, Long-term bladder function in patients with locally advanced cervical carcinoma treated with neoadjuvant chemotherapy and type 3–4 radical hysterectomy. Cancer 100(10), 2110–2117 (2004)
J. Hata, A. Onagi, R. Tanji, R. Honda-Takinami, K. Matsuoka, S. Hoshi, et al., Prevalence and predictors of postoperative detrusor underactivity after robot-assisted radical prostatectomy: A prospective observational study. Int. J. Urol. 28(7), 734–740 (2021)
C. Song, J. Lee, J.H. Hong, M.S. Choo, C.S. Kim, H. Ahn, Urodynamic interpretation of changing bladder function and voiding pattern after radical prostatectomy: A long-term follow-up. BJU Int. 106(5), 681–686 (2010)
M. Porena, E. Mearini, L. Mearini, A. Vianello, A. Giannantoni, Voiding dysfunction after radical retropubic prostatectomy: More than external urethral sphincter deficiency. Eur. Urol. 52(1), 38–45 (2007)
H.H. Yao, V. Hoe, R.T. Crump, S. Sengupta, H.E. O’Connell, K.V. Carlson, et al., Impact of radical prostatectomy on bladder function as demonstrated on urodynamics study – A systematic review. Neurourol. Urodyn. 40(2), 582–603 (2021)
G.E. Leach, B. Trockman, A. Wong, J. Hamilton, F. Haab, P.E. Zimmern, Post-prostatectomy incontinence: Urodynamic findings and treatment outcomes. J. Urol. 155(4), 1256–1259 (1996)
C. Huckabay, C. Twiss, A. Berger, V.W. Nitti, A urodynamics protocol to optimally assess men with post-prostatectomy incontinence. Neurourol. Urodyn. 24(7), 622–626 (2005)
C. Constantinou, F. Freiha, Impact of radical prostatectomy on the characteristics of bladder and urethra. J. Urol. 148(4), 1215–1219 (1992)
B. Kleinhans, E. Gerharz, M. Melekos, K. Weingärtner, T. Kälble, H. Riedmiller, Changes of urodynamic findings after radical retropubic prostatectomy. Eur. Urol. 35(3), 217–222 (1999)
J.C. Winters, R.A. Appell, R.R. Rackley, Urodynamic findings in postprostatectomy incontinence. Neurourol. Urodyn. 17(5), 493–498 (1998)
J. Foote, S. Yun, G.E. Leach, Postprostatectomy incontinence: Pathophysiology, evaluation, and management. Urol. Clin. N. Am. 18(2), 229–241 (1991)
A. Majoros, D. Bach, A. Keszthelyi, A. Hamvas, I. Romics, Urinary incontinence and voiding dysfunction after radical retropubic prostatectomy (prospective urodynamic study). Neurourol. Urodyn. 25(1), 2–7 (2006)
A. Giannantoni, E. Mearini, S.M. Di Stasi, L. Mearini, V. Bini, G. Pizzirusso, et al., Assessment of bladder and urethral sphincter function before and after radical retropubic prostatectomy. J. Urol. 171(4), 1563–1566 (2004)
G.E. Leach, S.K. Yun, Post-prostatectomy incontinence: Part I. The urodynamic findings in 107 men. Neurourol. Urodyn. 11(2), 91–97 (1992)
S.J. Kielb, J.Q. Clemens, Comprehensive urodynamics evaluation of 146 men with incontinence after radical prostatectomy. Urology 66(2), 392–396 (2005)
A. Groutz, J.G. Blaivas, D.C. Chaikin, J.P. Weiss, M. Verhaaren, The pathophysiology of post-radical prostatectomy incontinence: A clinical and video urodynamic study. J. Urol. 163(6), 1767–1770 (2000)
M.A. Ficazzola, V.W. Nitti, The etiology of post-radical prostatectomy incontinence and correlation of symptoms with urodynamic findings. J. Urol. 160(4), 1317–1320 (1998)
E.T. Goluboff, D.T. Chang, C.A. Olsson, S.A. Kaplan, Urological neurology and urodynamics: Urodynamics and the etiology of post-prostatectomy urinary incontinence: The initial Columbia experience. J. Urol. 153(3S), 1034–1037 (1995)
R. Minervini, R. Felipetto, G. Morelli, N. Fontana, S. Pampaloni, M. Notaro, et al., Bladder instability and incontinence after radical prostatectomy. Biomed. Pharmacother. 50(8), 383–385 (1996)
R. Chao, M.E. Mayo, Incontinence after radical prostatectomy: Detrusor or sphincter causes. J. Urol. 154(1), 16–18 (1995)
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 Springer Nature Singapore Pte Ltd.
About this entry
Cite this entry
Sebesta, E.M., Gleicher, S., Kowalik, C.G., Cohn, J.A., Stuart Reynolds, W., Dmochowski, R.R. (2022). Radical Pelvic Surgery. In: Liao, L., Madersbacher, H. (eds) Handbook of Neurourology. Springer, Singapore. https://doi.org/10.1007/978-981-16-7939-1_68-1
Download citation
DOI: https://doi.org/10.1007/978-981-16-7939-1_68-1
Received:
Accepted:
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-16-7939-1
Online ISBN: 978-981-16-7939-1
eBook Packages: Springer Reference MedicineReference Module Medicine