Long-term evaluation of renal function and neurogenic bladder following radical hysterectomy in patients with uterine cervical cancer

Bladder Cancer
20/07/2020

J Obstet Gynaecol Res. 2020 Jul 19. doi: 10.1111/jog.14394. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to determine whether radical hysterectomy (RH) affects renal function.

METHODS: Renal function was followed up in 83 patients with stage IB1-IIB cervical cancer who underwent RH during 2006-2015. Serum creatinine (sCre) levels were measured preoperatively and every year postoperatively. Estimated glomerular filtration rate (eGFR) was calculated using sCre levels. Patients who were unable to urinate by themselves or whose residual urine was ≥100 mL were referred to a urologist with the diagnosis of neurogenic bladder (NB). The relationship between NB occurrence and changes in sCre level or eGFR was evaluated respectively.

RESULTS: Urological intervention was required in 45 patients (54.2%), and self-urethral catheterization was performed in 41 (49.3%) patients. The NB and clean intermittent catheterization (CIC) groups exhibited significant increases in sCre levels, which were not observed in the non-NB or non-CIC groups. In the non-NB group, eGFR did not change following surgery. However, in the NB group, significant decreases in eGFRs were observed at postoperative 2 and 3 years and at final follow-up. There was no difference in the incidence of cardiovascular events between patients with and without NB.

CONCLUSION: In patients with NB following RH, a significant decrease in renal function was observed after postoperative 2 years.