What is urinary retention after cervical cancer surgery?

  Patients with post-operative cervical cancer have this concern. The patient with uterine fibroids in the next bed had her urinary catheter removed 3 days after surgery, but she needs to hang it for 2 weeks, which is inconvenient and prone to infection and pain. Sometimes, after 2 weeks, I still can’t remove the urinary catheter, and I have to measure the residual urine over and over again. It is not very annoying. Why is this?  It starts from the scope of surgery, cervical cancer patients need to perform radical cervical cancer surgery, the scope of surgery includes uterus, vagina, uterosacral ligament, cervical bladder ligament, etc. During surgery, it is necessary to separate the bladder from the anterior vaginal wall, it is necessary to perform a ureteral tunnel, deal with uterine arteries and veins, it is necessary to separate the ureter, so there is trauma to the urinary system, which is manifested in trauma to the surface of the bladder and the surface of the ureter, and some of the nerves innervated by the bladder will be truncated. Due to these traumas, most patients are unable to urinate on their own for 2 weeks after surgery, or they do not urinate on their own. A catheter will need to be inserted.  When can a catheter be removed after surgery: 2 weeks after surgery, most patients have some recovery of bladder function and are able to urinate on their own, but what is considered recovery in place? There is a clinical definition of residual urine, which is when the patient can still export part of the urine after the urethral catheter is removed and the patient urinates on his own, and then the urethral catheter is inserted immediately, usually, if the amount of urine exported is less than 100ml, the function is considered to be back to normal, otherwise, the urethral catheter continues to be inserted and the above operation is repeated after a week. Some patients with greater than 100ml of residual urine are overwhelmed by the repeated removal and insertion of urinary catheters and firmly refuse to reinsert them. What happens in this way? In this case, more urine is retained in the bladder without the patient being aware of it. After pressure, the urine enters the ureter retrogradely and is prone to urinary tract infection, and after pressure, it is also harmful to kidney function.  Since the above situation is more common among postoperative cervical cancer patients, even after medication such as neostigmine, individual patients are still unable to remove the urinary catheter six months after surgery and have urinary tract infection, which is painful, so doctors are also trying to find ways to improve this situation, such as performing radical cervical cancer surgery with preservation of bladder nerves, such as cystostomy for patients with long-term postoperative retention of urinary catheter, which can also improve the postoperative urinary tract infection It is also easier to observe the recovery of bladder function.