Postvoid Residual Volume After Radical Hysterectomy for Early-Stage Cervical Cancer : Predictive Factors and a Decision-Making Algorithm
Seminario, Naia (Hospital Universitari Vall d'Hebron)
Bebia, Vicente (Hospital Universitari Vall d'Hebron)
Aznar, Ana Luzarraga (Hospital Universitari Vall d'Hebron)
San Jose Moya, Marta (Hospital Universitari Vall d'Hebron)
Vallés, Elvira (Hospital Universitari Vall d'Hebron)
Bonaldo, Giulio (Hospital Universitari Vall d'Hebron)
Gil-Moreno, Antonio 1965- (Hospital Universitari Vall d'Hebron)
Angeles Fite, Martina Aida (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública

Data:	2025
Resum:	This retrospective study examined the normalization of bladder function after radical hysterectomy, identifying the predictive factors linked to postoperative bladder dysfunction and defining a postvoid residual volume threshold that could guide postoperative voiding management. A total of 67 patients with early-stage cervical cancer who underwent either type B1 or type C1 radical hysterectomy were recruited. By postoperative day 3, 73. 1% of patients had recovered normal voiding. Recovery was faster after B1 surgery than after C1 surgery, with a median recovery of 1 day and 2. 5 days, respectively. Type C1 radical hysterectomy was associated with a significantly higher risk of postoperative bladder dysfunction. At discharge, 19. 4% of patients still required catheterization. Based on these findings, a risk-adapted management algorithm was proposed: catheters can be safely removed on day 1 after B1 surgery, while C1 patients should undergo a voiding trial, with delayed catheter removal if postvoid residual volume is ≥170 mL. 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.
Ajuts:	'This research received no external funding.'
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Hysterectomy ; Radical ; Cervix neoplasm ; Urinary bladder dysfunction ; Residual urine ; Postoperative care ; Postoperative complications
Publicat a:	Cancers, Vol. 18 (December 2025) , art. 24, ISSN 2072-6694

DOI: 10.3390/cancers18010024
PMID: 41514537

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