Effect of laparoscopic hysterectomy on bladder neck and urinary symptoms.

OBJECTIVE

To assess the effect of laparoscopic hysterectomy (LH) on the mobility and position of bladder neck (BN) and urinary symptoms.

DESIGN

We assessed the BN and urinary symptoms of 151 patients by introital ultrasonography and questionnaires before and after LH.

SAMPLE: One hundred and fifty-one women who underwent LH from June 1999 to June 2001.

RESULTS

A significant decrease was noted in the number of women exhibiting one or more urinary symptoms from 81 (53.6%) preoperatively to 58 (38.4%) postoperatively (P < 0.01). The incidence of urinary frequency, mild stress incontinence and nocturia decreased significantly after laparoscopic hysterectomy (P < 0.01). Changes in other urinary symptoms following hysterectomy showed no statistical significance (P > 0.05). During straining, the postoperative position of the BN localised more dorsally (P < 0.01) and the ventral mobility of the BN decreased significantly following surgery (P < 0.05). There was no significant difference in the location of the BN with respect to the pubis at rest and during straining, in the cephalocaudal direction, before and after hysterectomy (P > 0.05).

CONCLUSION

Some patients experienced a substantial improvement of preoperative urinary symptoms following LH, partly as a result of a decrease in the hypermobility of BN.