How to prevent urinary retention after radical hysterectomy for cervical cancer

After radical hysterectomy for cervical cancer, there are varying degrees of bladder dysfunction, which can easily lead to postoperative urinary retention. How to reduce the occurrence of urinary retention after cervical cancer surgery? Nursing should pay attention to the following three aspects.

Pelvic floor muscle exercise

Assist the patient to do abdominal muscle exercises 2 days before the operation, contract the abdominal muscles when inhaling, relax when exhaling, 3 times a day, 10 minutes each time; from the 4th day after the operation, perform anal lifting and abdominal exercises on the bed, contract the anus first, then contract the vagina and urethra, produce the feeling of pelvic floor muscle lifting, contract when inhaling, relax when exhaling, maintain for 5 to 10 seconds each time, for 5 to 10 minutes, 3 times a day. As the body recovers, gradually increase the number and duration of exercises. From the 5th day after the operation, combine leg lifting exercises, start with lifting and lowering a single leg, gradually develop to lifting and lowering both legs, and finally lift both legs to do pedal exercises, 3 times a day, 5 to 10 minutes each time. Exercise in a gradually increasing manner according to the recovery of the body.

Urinary training

The catheter was clamped on the 10th day after surgery. The time for urination was determined according to each patient's urge to urinate or the degree of bladder fullness. Patients were asked to use the squat toilet method when urinating. Patients were reminded to participate in urination while urinating. The patient's mind was used to make him feel as if he was urinating normally. This imitation effect can avoid the patient's psychological stress reaction of worrying that he will not be able to urinate on his own after the catheter is removed, and the patient can gradually restore normal urination reflex awareness.

Preparation before extubation

On the 14th day after surgery, before removing the catheter, empty the bladder of urine first, then clamp the catheter and quickly drip 250ml of 5% sodium bicarbonate + 160,000 U of gentamicin into the bladder at a temperature of 36℃~37℃, so that the bladder is filled in a short time, which strongly stimulates the bladder wall, excites the parasympathetic nerves and produces a urination reflex. Keep the flushing fluid in the bladder for 10 minutes, then remove the catheter. After removal of the catheter, let the patient urinate immediately to avoid a full bladder and mental tension, which will affect the effect of spontaneous urination.