7a7ce62d1dfbfbbabb9d3dfe01b6a466 326218.pdf e5d54fff4c9f748d2855d3b8f4c3d7b6bc383326 326218.pdf afbca546c1c3ade3922c4c2b4b7f0a05bc3a412a0cebb74b8cdc9ad6a71e4cc7 326218.pdf Title: Postvoid Residual Volume After Radical Hysterectomy for Early-Stage Cervical Cancer: Predictive Factors and a Decision-Making Algorithm "2279 Subject: Objective: Our study evaluated the time to normalization of postvoid residual volume after radical hysterectomy and identified risk factors for postoperative bladder dysfunction. We also aimed to establish a predictive threshold for bladder dysfunction on the third postoperative day to develop a decision-making algorithm for postoperative voiding management. Methods: This retrospective, single-center study included early-stage cervical cancer patients undergoing type B1 or C1 radical hysterectomy. Factors associated with elevated postvoid residual volume were analyzed using logistic regression, and the threshold was determined using the Youden index. Results: 67 patients were included: 36 patients (53.7%) underwent C1 radical hysterectomy and 31 (46.3%) B1. At discharge, 13 (19.4%) patients required a catheter: 8 (61.5%) required intermittent catheterization, 5 (38.5%) had a Foley catheter. By postoperative day 3, 49 (73.1%) patients recovered their voiding function. The median time to postvoid residual volume recovery was 1 day (IQR: 1–2) for type B1 and 2.5 days (IQR: 2–5) for type C1 (p < 0.01). Compared with B1, C1 radicality was independently associated with a higher risk of postoperative voiding dysfunction (OR = 11.46; 95% CI: 1.75–75.24; p < 0.05). Based on these findings, we propose an algorithm for risk-adapted postoperative voiding management: B1 patients can safely have catheters removed on postoperative day 1 without a voiding trial, whereas C1 patients require one. C1 patients with postvoid residual volume 170 mL should have delayed catheter removal. Conclusions: Surgical radicality is a risk factor for postoperative bladder dysfunction. In type C1 radical hysterectomy, a postvoid residual volume 170 mL on the first postoperative day identifies patients at high risk of delayed recovery, supporting a tailored approach to postoperative voiding management. Keywords: hysterectomy; radical; cervix neoplasm; urinary bladder dysfunction; residual urine; postoperative care; postoperative complications Author: Naia Seminario, Vicente Bebia, Ana Luzarraga Aznar, Marta San José, Elvira Vallés, Giulio Bonaldo, Antonio Gil-Moreno and Martina Aida Angeles Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Sun Dec 21 07:59:31 2025 CET ModDate: Sun Dec 21 08:32:39 2025 CET Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1004051 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- VSPIKV+CMSY10 Type 1 Builtin yes yes yes 83 0 GCQGKN+URWPalladioL-Bold Type 1 Custom yes yes yes 84 0 MIKRSI+VnURWPalladioL Type 1 Custom yes yes yes 85 0 RQEANO+URWPalladioL-Roma Type 1 Custom yes yes yes 86 0 WWOBBR+URWPalladioL-Ital Type 1 Custom yes yes yes 87 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes yes 184 0 HGAGDO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 197 0 HGAGDM+PalatinoLinotype TrueType WinAnsi yes yes no 198 0 HGAGDK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 199 0 FHJFDE+PalatinoLinotype TrueType WinAnsi yes yes no 213 0 FHJFDE+PalatinoLinotype TrueType WinAnsi yes yes no 268 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-02-28 04:25:42 CET RepresentationInformation: 326218.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-02-27 13:24:25 CET Size: 1004051 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 364 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Item: Title: Methods Children: Item: Title: Patients and Study Design Item: Title: Postoperative Care Item: Title: Study Data Item: Title: Statistical Analysis Item: Title: Results Item: Title: Discussion Item: Title: Conclusions Item: Title: References Info: Title: Postvoid Residual Volume After Radical Hysterectomy for Early-Stage Cervical Cancer: Predictive Factors and a Decision-Making Algorithm "2279 Author: Naia Seminario, Vicente Bebia, Ana Luzarraga Aznar, Marta San José, Elvira Vallés, Giulio Bonaldo, Antonio Gil-Moreno and Martina Aida Angeles Subject: Objective: Our study evaluated the time to normalization of postvoid residual volume after radical hysterectomy and identified risk factors for postoperative bladder dysfunction. We also aimed to establish a predictive threshold for bladder dysfunction on the third postoperative day to develop a decision-making algorithm for postoperative voiding management. Methods: This retrospective, single-center study included early-stage cervical cancer patients undergoing type B1 or C1 radical hysterectomy. Factors associated with elevated postvoid residual volume were analyzed using logistic regression, and the threshold was determined using the Youden index. Results: 67 patients were included: 36 patients (53.7%) underwent C1 radical hysterectomy and 31 (46.3%) B1. At discharge, 13 (19.4%) patients required a catheter: 8 (61.5%) required intermittent catheterization, 5 (38.5%) had a Foley catheter. By postoperative day 3, 49 (73.1%) patients recovered their voiding function. The median time to postvoid residual volume recovery was 1 day (IQR: 1–2) for type B1 and 2.5 days (IQR: 2–5) for type C1 (p < 0.01). Compared with B1, C1 radicality was independently associated with a higher risk of postoperative voiding dysfunction (OR = 11.46; 95% CI: 1.75–75.24; p < 0.05). Based on these findings, we propose an algorithm for risk-adapted postoperative voiding management: B1 patients can safely have catheters removed on postoperative day 1 without a voiding trial, whereas C1 patients require one. C1 patients with postvoid residual volume 170 mL should have delayed catheter removal. Conclusions: Surgical radicality is a risk factor for postoperative bladder dysfunction. In type C1 radical hysterectomy, a postvoid residual volume 170 mL on the first postoperative day identifies patients at high risk of delayed recovery, supporting a tailored approach to postoperative voiding management. Keywords: hysterectomy; radical; cervix neoplasm; urinary bladder dysfunction; residual urine; postoperative care; postoperative complications Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Sun Dec 21 07:59:31 CET 2025 ModDate: Sun Dec 21 08:32:39 CET 2025 ID: 0x375a74ea9343ded6d51da7ef813da3c7, 0x89c0205c05edf069ab12ce679e8d6210 Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: VSPIKV+CMSY10 FontSubset: true FirstChar: 2 LastChar: 21 FontDescriptor: FontName: VSPIKV+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true ToUnicode: true Font: BaseFont: GCQGKN+URWPalladioL-Bold FontSubset: true FirstChar: 3 LastChar: 233 FontDescriptor: FontName: GCQGKN+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: MIKRSI+VnURWPalladioL FontSubset: true FirstChar: 225 LastChar: 225 FontDescriptor: FontName: MIKRSI+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: RQEANO+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 246 FontDescriptor: FontName: RQEANO+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: WWOBBR+URWPalladioL-Ital FontSubset: true FirstChar: 46 LastChar: 121 FontDescriptor: FontName: WWOBBR+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: QLBIEB+URWPalladioL-BoldItal FontSubset: true FirstChar: 110 LastChar: 112 FontDescriptor: FontName: QLBIEB+URWPalladioL-BoldItal Flags: Symbolic FontBBox: -170, -300, 1073, 935 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 34, 204, 124, 223 Annotation: Subtype: Link Rect: 88, 77, 152, 84 Annotation: Subtype: Link Rect: 34, 64, 119, 72 Annotation: Subtype: Link Rect: 34, 773, 130, 809 Annotation: Subtype: Link Rect: 515, 773, 560, 809 Annotation: Subtype: Link Rect: 108, 643, 119, 656 Annotation: Subtype: Link Rect: 192, 643, 203, 656 Annotation: Subtype: Link Rect: 305, 643, 316, 656 Annotation: Subtype: Link Rect: 135, 629, 146, 642 Annotation: Subtype: Link Rect: 274, 629, 285, 642 Annotation: Subtype: Link Rect: 409, 27, 560, 37 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 234, 552, 241, 560 ActionDest: 44 Annotation: Subtype: Link Rect: 243, 552, 250, 560 ActionDest: 44 Annotation: Subtype: Link Rect: 468, 538, 475, 547 ActionDest: 44 Annotation: Subtype: Link Rect: 478, 538, 485, 547 ActionDest: 44 Annotation: Subtype: Link Rect: 413, 496, 420, 505 ActionDest: 44 Annotation: Subtype: Link Rect: 420, 496, 427, 505 ActionDest: 44 Annotation: Subtype: Link Rect: 428, 496, 435, 505 ActionDest: 44 Annotation: Subtype: Link Rect: 438, 496, 445, 505 ActionDest: 44 Annotation: Subtype: Link Rect: 364, 398, 371, 407 ActionDest: 44 Annotation: Subtype: Link Rect: 374, 398, 381, 407 ActionDest: 44 Annotation: Subtype: Link Rect: 467, 384, 474, 393 ActionDest: 44 Annotation: Subtype: Link Rect: 477, 384, 489, 393 ActionDest: 161 Annotation: Subtype: Link Rect: 197, 343, 209, 352 ActionDest: 161 Annotation: Subtype: Link Rect: 210, 343, 221, 352 ActionDest: 161 Annotation: Subtype: Link Rect: 222, 343, 234, 352 ActionDest: 161 Annotation: Subtype: Link Rect: 490, 329, 502, 338 ActionDest: 161 Annotation: Subtype: Link Rect: 503, 328, 514, 338 ActionDest: 161 Annotation: Subtype: Link Rect: 517, 328, 529, 338 ActionDest: 161 Annotation: Subtype: Link Rect: 249, 301, 261, 310 ActionDest: 161 Annotation: Subtype: Link Rect: 262, 301, 274, 310 ActionDest: 161 Annotation: Subtype: Link Rect: 274, 301, 286, 310 ActionDest: 161 Annotation: Subtype: Link Rect: 378, 273, 390, 282 ActionDest: 161 Annotation: Subtype: Link Rect: 391, 273, 403, 282 ActionDest: 161 Annotation: Subtype: Link Rect: 403, 273, 415, 282 ActionDest: 161 Annotation: Subtype: Link Rect: 345, 245, 357, 254 ActionDest: 161 Annotation: Subtype: Link Rect: 357, 245, 369, 254 ActionDest: 161 Annotation: Subtype: Link Rect: 370, 245, 382, 254 ActionDest: 161 Annotation: Subtype: Link Rect: 388, 217, 400, 226 ActionDest: 161 Annotation: Subtype: Link Rect: 400, 217, 412, 226 ActionDest: 161 Annotation: Subtype: Link Rect: 413, 217, 425, 226 ActionDest: 161 Annotation: Subtype: Link Rect: 294, 175, 301, 184 ActionDest: 44 Annotation: Subtype: Link Rect: 304, 106, 316, 115 ActionDest: 161 Annotation: Subtype: Link Rect: 319, 106, 331, 115 ActionDest: 161 Annotation: Subtype: Link Rect: 409, 27, 560, 37 Page: Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 516, 506, 528, 515 ActionDest: 161 Annotation: Subtype: Link Rect: 199, 312, 211, 321 ActionDest: 161 Annotation: Subtype: Link Rect: 409, 27, 560, 37 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 276, 686, 283, 695 ActionDest: 34 Annotation: Subtype: Link Rect: 409, 27, 560, 37 Page: Sequence: 5 Annotations: Annotation: Subtype: Link Rect: 390, 533, 397, 545 ActionDest: 107 Annotation: Subtype: Link Rect: 480, 477, 487, 489 ActionDest: 108 Annotation: Subtype: Link Rect: 467, 83, 474, 95 ActionDest: 108 Annotation: Subtype: Link Rect: 409, 27, 560, 37 Page: Sequence: 6 Annotations: Annotation: Subtype: Link Rect: 409, 27, 560, 37 Page: Sequence: 7 Annotations: Annotation: Subtype: Link Rect: 364, 686, 376, 695 ActionDest: 161 Annotation: Subtype: Link Rect: 531, 658, 543, 667 ActionDest: 161 Annotation: Subtype: Link Rect: 544, 658, 556, 667 ActionDest: 161 Annotation: Subtype: Link Rect: 455, 644, 467, 653 ActionDest: 161 Annotation: Subtype: Link Rect: 470, 644, 482, 653 ActionDest: 161 Annotation: Subtype: Link Rect: 359, 616, 371, 625 ActionDest: 161 Annotation: Subtype: Link Rect: 245, 533, 257, 542 ActionDest: 161 Annotation: Subtype: Link Rect: 544, 491, 556, 500 ActionDest: 161 Annotation: Subtype: Link Rect: 437, 421, 449, 430 ActionDest: 161 Annotation: Subtype: Link Rect: 487, 365, 499, 374 ActionDest: 258 Annotation: Subtype: Link Rect: 209, 324, 221, 333 ActionDest: 161 Annotation: Subtype: Link Rect: 230, 240, 242, 249 ActionDest: 161 Annotation: Subtype: Link Rect: 242, 240, 254, 249 ActionDest: 161 Annotation: Subtype: Link Rect: 255, 240, 267, 249 ActionDest: 258 Annotation: Subtype: Link Rect: 325, 115, 332, 124 ActionDest: 44 Annotation: Subtype: Link Rect: 409, 27, 560, 37 Page: Sequence: 8 Annotations: Annotation: Subtype: Link Rect: 433, 661, 445, 670 ActionDest: 258 Annotation: Subtype: Link Rect: 393, 394, 399, 406 ActionDest: 257 Annotation: Subtype: Link Rect: 409, 27, 560, 37 Page: Sequence: 9 Annotations: Annotation: Subtype: Link Rect: 409, 27, 560, 37 Page: Sequence: 10 Annotations: Annotation: Subtype: Link Rect: 437, 296, 474, 307 Annotation: Subtype: Link Rect: 481, 296, 517, 307 Annotation: Subtype: Link Rect: 190, 271, 227, 282 Annotation: Subtype: Link Rect: 233, 271, 269, 282 Annotation: Subtype: Link Rect: 430, 245, 468, 256 Annotation: Subtype: Link Rect: 474, 245, 510, 256 Annotation: Subtype: Link Rect: 405, 207, 442, 218 Annotation: Subtype: Link Rect: 407, 182, 445, 193 Annotation: Subtype: Link Rect: 427, 156, 464, 167 Annotation: Subtype: Link Rect: 95, 131, 133, 141 Annotation: Subtype: Link Rect: 402, 105, 440, 116 Annotation: Subtype: Link Rect: 197, 67, 234, 78 Annotation: Subtype: Link Rect: 409, 27, 560, 37 Page: Sequence: 11 Annotations: Annotation: Subtype: Link Rect: 293, 744, 330, 754 Annotation: Subtype: Link Rect: 59, 706, 96, 716 Annotation: Subtype: Link Rect: 102, 706, 138, 716 Annotation: Subtype: Link Rect: 59, 668, 96, 678 Annotation: Subtype: Link Rect: 102, 668, 138, 678 Annotation: Subtype: Link Rect: 158, 642, 195, 652 Annotation: Subtype: Link Rect: 201, 642, 237, 652 Annotation: Subtype: Link Rect: 59, 604, 96, 614 Annotation: Subtype: Link Rect: 484, 577, 521, 588 Annotation: Subtype: Link Rect: 288, 539, 326, 550 Annotation: Subtype: Link Rect: 462, 488, 499, 499 Annotation: Subtype: Link Rect: 95, 450, 133, 461 Annotation: Subtype: Link Rect: 276, 411, 314, 422 Annotation: Subtype: Link Rect: 379, 386, 417, 397 Annotation: Subtype: Link Rect: 423, 386, 459, 397 Annotation: Subtype: Link Rect: 520, 373, 557, 384 Annotation: Subtype: Link Rect: 59, 361, 95, 371 Annotation: Subtype: Link Rect: 192, 322, 230, 333 Annotation: Subtype: Link Rect: 236, 322, 272, 333 Annotation: Subtype: Link Rect: 131, 297, 168, 307 Annotation: Subtype: Link Rect: 328, 271, 365, 282 Annotation: Subtype: Link Rect: 247, 233, 284, 244 Annotation: Subtype: Link Rect: 362, 207, 399, 218 Annotation: Subtype: Link Rect: 194, 169, 231, 180 Annotation: Subtype: Link Rect: 144, 131, 182, 141 Annotation: Subtype: Link Rect: 409, 27, 560, 37 Page: Sequence: 12 Annotations: Annotation: Subtype: Link Rect: 318, 743, 356, 754 Annotation: Subtype: Link Rect: 335, 718, 372, 729 Annotation: Subtype: Link Rect: 378, 718, 414, 729 Annotation: Subtype: Link Rect: 409, 27, 560, 37 Checksum: bca12c6b Type: CRC32 Checksum: 7a7ce62d1dfbfbbabb9d3dfe01b6a466 Type: MD5 Checksum: e5d54fff4c9f748d2855d3b8f4c3d7b6bc383326 Type: SHA-1 Checksum: afbca546c1c3ade3922c4c2b4b7f0a05bc3a412a0cebb74b8cdc9ad6a71e4cc7 Type: SHA-256