J Obstet Gynaecol Res. 2026 Nov;52(11):e70541. doi: 10.1111/jog.70541.

ABSTRACT

AIM: To systematically review the evidence on postoperative bladder management and rehabilitation strategies for women undergoing radical hysterectomy for cervical cancer.

METHODS: A systematic review was conducted using PubMed/MEDLINE. Studies evaluating postoperative bladder management or rehabilitation interventions in women undergoing radical hysterectomy for cervical cancer were included. Eligible interventions comprised catheter management, trial-of-void (TOV) strategies, pelvic floor exercises, integrated care, and electrical stimulation. Study characteristics, urinary outcomes, quality of life (QoL), and risk of bias were assessed descriptively.

RESULTS: Eight studies were included. Interventions included intermittent catheterization continuity care, TOV strategies, enhanced recovery after surgery (ERAS)-based pelvic floor exercises, integrated nursing care, early pelvic floor muscle exercises, transcutaneous electrical nerve stimulation (TENS), and transcutaneous electrical acupoint stimulation (TEAS). Intermittent catheterization continuity care was associated with faster bladder function recovery and improved QoL. Pelvic floor exercises and integrated care were associated with improvements in urinary symptoms, pelvic floor muscle strength, or QoL. TENS was associated with a lower urinary retention rate in a retrospective cohort study. In a randomized controlled trial, TEAS improved several secondary bladder-emptying outcomes and QoL, but did not significantly reduce the primary outcome of urinary retention. Heterogeneity in study designs, interventions, and outcome definitions limited comparisons across studies.

CONCLUSIONS: Structured postoperative bladder management and rehabilitation may improve bladder recovery and patient-reported outcomes after radical hysterectomy for cervical cancer. However, the certainty of evidence remains limited. Further well-designed prospective studies and randomized controlled trials using standardized outcome measures are needed to determine optimal rehabilitation strategies.

PMID:43003416 | DOI:10.1111/jog.70541