Comparison of Lower Urinary Tract Function Before and After Undergoing Open Abdominal Hysterectomy: A Prospective Cohort Study

Abstract

Background: Radical hysterectomies are known to affect the lower urinary tract, with the intensity being directly proportional to the radicality of the hysterectomy. Currently, very few studies suggest that a reduction in the radicality of hysterectomy might decrease urological morbidity. Objectives: The present study primarily aimed to compare the uroflowmetry parameters and symptoms score (ICIQ-FLUTS) in patients before and after undergoing open abdominal hysterectomy and secondarily to compare the results in the present study with those in the literature worldwide. Methods: This prospective cohort study was conducted in Belagavi, Karnataka, India, from February 2023 to July 2024 on 30 patients. Uroflowmetry and ICIQ-FLUTS were recorded 1 day preoperatively and postoperatively on days 10, 30, 90, and 180. Data were entered in Excel and analyzed using SPSS version 22.0. Intergroup comparisons of continuous means were performed using one-way ANOVA, and intragroup comparisons were analyzed post hoc using LSD analysis. Results: In the 30 samples collected, the mean age was 51.90 ± 11.98 years, and the mean time for surgery was 1 hour 39 minutes ± 33 minutes. Twenty percent, 43.33%, and 36.7% of patients underwent Wertheim’s hysterectomy, simple hysterectomy, and total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAHBSO) + omentectomy/bilateral pelvic lymph node dissection (PLND), respectively. The mean blood transfusion required was 0.2 pints. Time for surgery and the need for blood transfusion were considered surrogates for the complexity of surgery. No statistically significant difference was noted when the results were compared as per the study protocol. Conclusions: Current nerve-sparing hysterectomies are associated with minimal urological morbidities and provide a good quality of life, and thus should be performed whenever possible. However, the results are not generalizable.