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Minerva Obstetrics and Gynecology 2021 Dec 14

DOI: 10.23736/S2724-606X.21.05008-9


language: English

Early prediction of urinary retention following radical hysterectomy by 18FFDG PET/CT Imaging

Tima DAVIDSON 1, 2, Yonatan YAKOBI 2, 3, knaana NAYRUZ 1, Gabriel LEVIN 4 , Jacob KORACH 2, 3, Tamar PERRI 4

1 Department of Nuclear Medicine, Chaim Sheba Medical Center, Tel Hashomer, Israel; 2 Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel; 3 Department of Gynecologic Oncology, Chaim Sheba Medical Center, Tel Hashomer, Israel; 4 Department of Gynecologic Oncology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel


INTRODUCTION: Radical hysterectomy for early cervical cancer is associated with post-operative bladder dysfunction. Post-operative imaging by 18F-FDG PET/CT scanning is often performed to rule out recurrence. Since women are instructed to empty the bladder before imaging, we aim to study if scanned abnormal residual bladder volume is associated with future urinary symptoms.
METHODS: Women who underwent radical hysterectomy for cervical cancer between July 2010 and January 2019 were included in the study. Multi-Modality Tumor Tracking® (MMTT) was used to measure residual urinary volume on 18F-FDG PET/CT scans before and after hysterectomy. Demographic, clinical parameters, and urinary tract signs and symptoms, were evaluated among the cohort.
RESULTS: Overall, 64 patients were included. Among those, in 24 (38%) the bladder volume reached ≥150 cm3 on postoperative 18F-FDG PET/CT scans. Of these, 9 (37.5%) had voiding difficulties of some degree. In 3 (12.5%) women, the 18F-FDG PET/CT scan has preceded their complaints of voiding difficulties by 2−4 months. Of the 40 women (62%) whose postoperative bladder volumes were <150 cm3, only 1 (2.5%) had urinary retention. Rate of symptomatic voiding difficulties was higher in the post-void volume ≥150 cm3 group; 13 (54.1%) vs. 6 (15.0%), p<0.002, Odds Ratio 95% Confidence Interval 6.6 (2.0-21.8), p=0.001.
CONCLUSIONS: Measuring bladder volume on postoperative 18F-FDG PET/CT may facilitate early identification of urinary retention, possibly enabling early treatment and possibly preventing complications.

KEY WORDS: Bladder volume; Cervical cancer; Early detection; Urine retention; 18FFDG PET/CT

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