[Early bladder function disorders following Wertheim surgery. Causes and therapeutic consequences].

The bladder function of forty five women was studied once before and three times following a Wertheim Operation for Carcinoma of the Cervix. Three quarters of the patients had a diminished bladder capacity two weeks after surgery with an increased bladder filling pressure and a decreased urethral occlusion pressure. After eight and twenty weeks the pre-operative state was almost reached. However there was no complete restoration of the function at that time. Almost all women had a disturbance of the bladder sensitivity. Modern investigations of bladder physiology show that the lax bladder is an expected post-operative neurogenic problem of the vesical plexus. At first this is masked by a hypertonic bladder due to muscle trauma. The postoperative decrease of the urethral occlusion pressure appears to be caused by a partial injury of sympathic nerve fibers. The problem of functional infravesical obstruction is discussed. The treatment is at first accomplished by general perioperative measures. Later on receptor effective drugs are used as necessary following a repeat urodynamic investigation.