A prospective study of nerve-sparing radical hysterectomy for uterine cervical carcinoma in Taiwan.

Abstract

OBJECTIVE:

Surgical therapy for cervical carcinoma carries a significant risk of functional impairment to the bladder. This study evaluates the feasibility and complications of nerve-sparing radical hysterectomy (NRH) in Taiwan.

METHODS:

Between March 2010 and March 2011, consecutive patients diagnosed with early stage cervical cancer (FIGO stage Ia2 to Ib1) and tumor size < 3 cm were recruited prospectively to undergo NRH or conventional radical hysterectomy (RH). Patients with histories of urinary stress incontinence or bladder dysfunction disease were excluded. A modified Tokyo nerve-sparing radical hysterectomy was performed.

RESULTS:

A total of 30 patients were enrolled. Among these, 18 patients underwent NRH with successful bilaterally nerve-sparing procedures in 15 cases (83%), unilaterally nerve-sparing procedures in 2 cases (11%), and a failure in 1 case (6%). The indwelling catheter was removed on postoperative day 6. The mean±SD duration from operation to spontaneous voiding was 6.8 ± 1.5 days for women who underwent NRH; the corresponding duration for women who underwent RH or failed NRH was 20.6 ± 3 days. None of the patients who underwent NRH required intermittent catheterization. All 12 patients who underwent RH needed self-catheterization after discharge. There was a significant reduction in the incidence of postoperative self-catheterization (p<0.01) and bladder dysfunction (p<0.006). Average satisfaction score analyzed by the Likert-scale questionnaire was 4.5 for the NRH group and 1.9 for RH group (p<0.0001).

CONCLUSIONS:

We concluded that the new technique of NRH can reduce postoperative bladder dysfunctions.

• Authors: Chih-Jen Tseng, Huang-Pin Shen, Yu-Hsiang Lin, Chung-Yuan Lee, Will Wei-Cheng Chiu
• Journal: Taiwanese journal of obstetrics & gynecology (Taiwan J Obstet Gynecol) Vol. 51 Issue 1 Pg. 55-9 (Mar 2012) ISSN: 1875-6263 [Electronic] China (Republic : 1949- )
• PMID: 22482969 (Publication Type: Controlled Clinical Trial, Journal Article)
• Copyright: Copyright © 2012. Published by Elsevier B.V.

Topics

• Adenocarcinoma (pathology, surgery)
• Adult
• Carcinoma, Squamous Cell (pathology, surgery)
• Female
• Humans
• Hysterectomy (adverse effects, methods)
• Middle Aged
• Organ Sparing Treatments
• Patient Satisfaction
• Peripheral Nerve Injuries (complications, prevention & control)
• Recovery of Function
• Statistics, Nonparametric
• Taiwan
• Time Factors
• Urinary Bladder (innervation, physiopathology)
• Urinary Catheterization
• Urinary Retention (etiology, therapy)
• Uterine Cervical Neoplasms (pathology, surgery)