The Impact of Early Postoperative Pelvic Floor Muscle Exercise on Urinary Retention and Urodynamics after Radical Hysterectomy for Cervical Cancer.

BACKGROUND

Radical hysterectomy effectively treats cervical cancer and extends patient survival but may cause postoperative urinary retention. This study examined the effect of early pelvic floor muscle exercise after radical hysterectomy for cervical cancer on reducing urinary retention and influencing urodynamic aspects.

METHODS

The study focused on patients who underwent radical hysterectomy for cervical cancer at the First Affiliated Hospital of Bengbu Medical University between January 2021 and December 2024. Clinical data, urinary retention, catheter replacement, dysuria, residual bladder urine volume, self-perception and comfort levels were compared. Logistic regression analysed the significance of early exercises on urinary retention risk.

RESULTS

A total of 202 patients with cervical cancer after radical operation were included, with 92 in the intervention group and 110 in the control group. After propensity score matching, 83 patients with early postoperative pelvic floor muscle exercise were in the intervention group, and 83 clinically-matched non-exercising patients were in the control group. We found no significant differences in general characteristics (p > 0.050). The intervention group had lower urinary retention, dysuria rates and less residual urine volume (p < 0.050) than the control group, with no significant differences in catheter replacement rate or incontinence prevalence (p > 0.050). At 1 and 2 weeks post-operation, patients had lower Self-Perceived Burden Scale (SPBS) scores and higher Kolcaba General Comfort Questionnaire (GCQ) scores than pre-treatment, with the intervention group having significantly lower SPBS and higher GCQ scores than the control group (p < 0.050). Significant inter-group, time-related and interaction effects were found for SPBS and GCQ score changes (p < 0.050). Univariate analysis showed a high proportion of clinical stages IB and IIA in patients with urinary retention and few post-operative exercise-doers in the retention group (p < 0.050). Multivariate regression indicated that early exercises protected against urinary retention (odds ratio (OR) (95% CI) = 0.329 (0.129-0.839), p = 0.020).

CONCLUSIONS

Early postoperative pelvic floor muscle exercise can enhance bladder function, reduce urinary retention risk and improve patient comfort after radical hysterectomy for cervical cancer.