The effect of Wertheim hysterectomy upon bladder and urethral function

Abstract Bladder and urethral function after Wertheim hysterectomy was assessed by cystometry and urethral pressure profiles. There was a marked reduction in bladder compliance with a striking rise in baseline bladder pressure during bladder filling, and hyperreflexia with involuntary contractions of the detrusor muscle at low bladder capacity. This was attributed to a loss of sympathetic beta-adrenergic inhibition of the detrusor muscle and, possibly, a loss of sympathetic alpha-adrenergic modulation of parasympathetic stimulation of the detrusor muscle. There was a significant decrease in the urethral pressure profile which was greatest in patients with the highest preoperative urethral pressures. This was attributed to loss of sympathetic alpha-adrenergic stimulation of urethral smooth muscle.