Shiyan Wang1,2, Runzhi Wang3, Hongwu Wen4, Yunong Gao5, Qiubo Lv6, Hongyu Li7, Sumei Wang8, Yanlong Wang9, Qing Liu10, Jinsong Han11, Haibo Wang12, Yi Li13, Qing Wang1,2, Tingting Cao1,2, Sha Wang1,2, Huaxin Sun1,2, Zhiqi Wang1,2, Xiuli Sun1,2, Jianliu Wang1,2. 1. Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China. 2. Beijing Key Laboratory of Female Pelvic Floor Disorders, Beijing, China. 3. Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 4. Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China. 5. Department of Gynecology, Peking University Cancer Hospital and Institute, Beijing, China. 6. Department of Obstetrics and Gynecology, Beijing Hospital, Beijing, China. 7. Department of Obstetrics and Gynecology, Zhengzhou University Third Hospital, Zhengzhou, China. 8. Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. 9. Department of Obstetrics and Gynecology, Women and Children Health Hospital of Xiamen, Xiamen, China. 10. Department of Obstetrics and Gynecology, Women and Children Health Hospital of Gansu, Lanzhou, China. 11. Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China. 12. Peking University Clinical Research Institute, Peking University Medical Department, Beijing, China. 13. Medical Informatics Center, Peking University Medical Department, Beijing, China.
Abstract
AIMS: To assess the pelvic floor function in cervical cancer patients after radical hysterectomy and its relationship with urinary incontinence (UI). METHODS: Cervical cancer patients who underwent radical hysterectomy were recruited from 18 hospitals in China from January 2012 to March 2015. Pelvic floor examinations were conducted by measuring the pelvic floor muscle strength, fatigue of pelvic floor muscle fatigue, dynamic pressure of vaginal, nerve injury, A3 feedback, muscle potential, static tension, and dynamic tension. Postoperative urinary incontinence (UI) was identified using the International Consultation on Incontinence Questionnaire. Multivariable logistic regression analysis was used to assess the association of pelvic floor function examination results with postoperative UI. RESULTS: Totally 169 patients were included in this study. The prevalence of UI was 39.6% (67/169). The proportion of abnormal fatigue of Type I muscle (64% vs. 36%, p = .04) and abnormal A3 feedback (53.9% vs. 46.1%, p = .03) were higher among patients with postoperative UI compared to those without UI. In the multivariable analysis, abnormal fatigue of Type I muscle (odds ratio [OR] = 3.73, 95% confidence interval [CI]: 1.42-9.84), abnormal A3 feedback (OR = 2.40, 95% CI: 1.04-5.51), and length of resected vagina > 3 cm (OR = 3.44, 95% CI: 1.27-9.31) were associated with postoperative UI. Compared to laparoscopy, laparotomy was less likely to cause postoperative UI (OR = 0.12, 95% CI:0.04-0.33). CONCLUSIONS: The abnormal function of the pelvic floor muscle is related to postoperative UI. Early assessment among these patients is needed to prevent the development of pelvic floor disorder postoperatively.
AIMS: To assess the pelvic floor function in cervical cancerpatients after radical hysterectomy and its relationship with urinary incontinence (UI). METHODS: Cervical cancerpatients who underwent radical hysterectomy were recruited from 18 hospitals in China from January 2012 to March 2015. Pelvic floor examinations were conducted by measuring the pelvic floor muscle strength, fatigue of pelvic floor muscle fatigue, dynamic pressure of vaginal, nerve injury, A3 feedback, muscle potential, static tension, and dynamic tension. Postoperative urinary incontinence (UI) was identified using the International Consultation on Incontinence Questionnaire. Multivariable logistic regression analysis was used to assess the association of pelvic floor function examination results with postoperative UI. RESULTS: Totally 169 patients were included in this study. The prevalence of UI was 39.6% (67/169). The proportion of abnormal fatigue of Type I muscle (64% vs. 36%, p = .04) and abnormal A3 feedback (53.9% vs. 46.1%, p = .03) were higher among patients with postoperative UI compared to those without UI. In the multivariable analysis, abnormal fatigue of Type I muscle (odds ratio [OR] = 3.73, 95% confidence interval [CI]: 1.42-9.84), abnormal A3 feedback (OR = 2.40, 95% CI: 1.04-5.51), and length of resected vagina > 3 cm (OR = 3.44, 95% CI: 1.27-9.31) were associated with postoperative UI. Compared to laparoscopy, laparotomy was less likely to cause postoperative UI (OR = 0.12, 95% CI:0.04-0.33). CONCLUSIONS: The abnormal function of the pelvic floor muscle is related to postoperative UI. Early assessment among these patients is needed to prevent the development of pelvic floor disorder postoperatively.