الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Hysterectomy is the most common gynecological surgery. twenty percent of women will have had hysterectomy by the time they are fifty, mostly due to menstrual disorders. (1,2) Total hysterectomy involves the surgical removal of the uterus and the cervix. hysterectomy may cause pelvic nerve injury which produces long term bladder dysfunction.(2) Namely, nerve damage to the pelvic plexus is associated with bladder symptoms.(4,5).Urodynamic studies are the gold standard for identifying urinary dysfunction on other hand, surveys and questionnaires may be useful .(5)Urinary incontinence (UI) is a frequent condition after hysterectomy. The most common clinical types of UI are stress urinary incontinence and urge incontinence. (8) Certain risk factors have been linked to higher odds of developing UI after hysterectomy. Two most common clinical types are stress urinary incontinence and urge incontinence. For example, Woman who are older, multiparous and obese, those using particular medications (as diuretics),those with chronic illness and a favorable family history, and those who have previously undergone pelvic surgery have all been recognized as being at risk of having urinary incontinence.(9,10The incidence of Urge Urinary incontinence may be much more than stress urinary incontinence because of the increase in bladder sensitivity after hysterectomy, due to neurological impairment.(12)Because the onset of urinary incontinence after hysterectomy may be delayed Long-term follow-up for outcomes after hysterectomy is crucial.(3)
Urodynamics are means of monitoring the difference between pressure-flow of the bladder and the urethra for the purpose of defining the functional status of the lower urinary tract. The ultimate goal of urodynamics is correction the diagnosis of lower urinary tract dysfunction depends on its pathophysiology. (14) Results from many previous studies relating hysterectomy to adverse effects of the lower urinary tract have been inconsistent.(17)
Regardless of age a French study involving 1700 women found that having hysterectomy raises the incidence of stress and urge incontinence. (19)
On the other hand, analysis of studies conducted on urodynamic before and after hysterectomy revealed that “Hysterectomy due to benign gynecological disorders may even enhance certain aspects of urine function without having a negative effect on urodynamic outcomes or increasing the chance of unpleasant symptoms. (22)
Why the contradicting results? Many factors are involved, the more evident ones being the size and design of the study as well as the duration of the follow-up. Mostly, the results depend on the reason for the hysterectomy and whether a bladder suspension was done at the same time. Two common reasons for hysterectomy are fibroids and uterine prolapse. (22)
The most commonly reported urinary complaints proved by urodynamic changes after total hysterectomy include urinary incontinence, urine retention, and straining during voiding. In addition to voiding dysfunction, impairment of bladder sensation, alteration of bladder capacity and bladder compliance, compromise of detrusor function. (28–31)
The aim was to evaluate the Lower urinary Tract Function using urodynamics before and after Total Hysterectomy by defining urodynamic changes after total hysterectomy as well as the impact of total hysterectomy on the lower urinary tract dysfunction. This study was conducted on patients who was subjected to do total hysterectomy due to benign condition at Elshatby Maternity university Hospital. Multichannel urodynamic Machine “MMS LABORIE” was used for urodynamic evaluation. Data were fed to the computer and analyzed using IBM SPSS software package version 20.0.