DOI QR코드

DOI QR Code

Effect of Laparoscopic Nerve-sparing Radical Hysterectomy on Bladder Function, Intestinal Function Recovery and Quality of Sexual Life in Patients with Cervical Carcinoma

  • Chen, Long (Gynecology Department, Qingdao Municipal Hospital) ;
  • Zhang, Wei-Na (Gynecology Department, Qingdao Municipal Hospital) ;
  • Zhang, Sheng-Miao (Gynecology Department, Qingdao Municipal Hospital) ;
  • Yang, Zhi-Hao (College of Life Science, Sichuan University) ;
  • Zhang, Ping (Gynecology Department, Qingdao Municipal Hospital)
  • Published : 2015.01.22

Abstract

Objective: To investigate bladder and intestinal function recovery and quality of sexual life after laparoscopic nerve-sparing radical hysterectomy (LNRH) for treatment of early invasive cervical carcinoma. Methods: Subjects included patients who underwent radical hysterectomy by laparotomy who were randomly assigned to 2 groups: 30 patients who underwent LNRH and 35 classical laparoscopic radical hysterectomy (LRH). We assessed the patients general clinical information, surgical characteristics, pathological findings, and adjuvant therapies. A urodynamic study was used to assess bladder function. Intestinal function recovery and quality of sexual life were evaluated by questionnaire. Results: No significant differences were found in age, surgery characteristics, pathological findings, adjuvant therapies, and main adverse effects between the 2 groups. The mean duration of the postoperative catheterization (DPC) in group LNRH was shorter than that in group LRH (P < 0.001). The maximum flow rate, maximum cystometric capacity, maximum detrusor pressure and urinary complications in group LNRH were better than those in group LRH. The quality of sexual life evaluated according to the female sexual function index (FSFI) was better in group LNRH than in those who underwent LRH. The intestinal function of patients in group LNRH also recovered better compared with patients in group LRH.

Keywords

References

  1. Bergmark K, Avall-Lundqvist E, Dickman PW, et al (2006). Lymphedema and bladder-emptying difficulties after radical hysterectomy for early cervical cancer and among population controls. Int J Gynecol Cancer, 16, 1130-9. https://doi.org/10.1111/j.1525-1438.2006.00601.x
  2. Bergmark K, Avall-Lundqvist E, Dickman PW, et al (1999). Vaginal changes and sexuality in women with a history of cervical cancer. N Engl J Med, 340, 1383-9. https://doi.org/10.1056/NEJM199905063401802
  3. Chen Y, Li Y, Xu HC, et al (2013). Clinical analysis on nervesparing laparoscopy radical hysterectomy in treatment of early stage cervical cancer. Zhonghua Fu Chan Ke Za Zhi, 44, 359-63.
  4. Covens A, Rosen B, Murphy J, et al (2001). Changes in the demographics and perioperative care of stage IA (2) /IB (1) cervical cancer over the past 16 years. Gynecol Oncol, 81, 133-7. https://doi.org/10.1006/gyno.2001.6158
  5. Fotiou S, Tserkezoglou A, Hatzieleftheriou G, et al (1997). Class III vs class II radical hysterectomy in stage IB cervical carcinoma: a comparison of morbidity and survival. Int J Gynecol Cancer, 7, 117-21. https://doi.org/10.1046/j.1525-1438.1997.00430.x
  6. Jensen PT, Groenvold M, Klee MC, et al (2004). Early-stage cervical carcinoma, radical hysterectomy, and sexual function. A longitudinal study. Cancer, 100, 97-106. https://doi.org/10.1002/cncr.11877
  7. Hwang YY, Moon H, Cho SH, et al (2001). Ten-year survival of patients with locally advanced, stage ib-iib cervical cancer after neoadjuvant chemotherapy and radical hysterectomy. Gynecol Oncol, 82, 88-3. https://doi.org/10.1006/gyno.2001.6204
  8. Hockel M, Konerding MA, Heussel CP et al (1998). Liposuctionassisted nerve-sparing extended radical hysterectomy: oncologic rationale, surgical anatomy, and feasibility study. Am J Obstet Gynecol, 178, 971-6. https://doi.org/10.1016/S0002-9378(98)70533-2
  9. Jensen PT, Groenvold M, Klee MC, et al (2004). Early-stage cervical carcinoma, radical hysterectomy, and sexual function. A longitudinal study. Cancer, 100, 97-106. https://doi.org/10.1002/cncr.11877
  10. Liang Z, Chen Y, Xu H, Li Y, Wang D et al (2010). Laparoscopic nerve-sparing radical hysterectomy with fascia space dissection technique for cervical cancer: description of technique and outcomes. Gynecol Oncol, 119, 202-7. https://doi.org/10.1016/j.ygyno.2010.06.033
  11. Pieterse QD, Maas CP, ter Kuile MM, et al (2006). An observational longitudinal study to evaluate miction, defecation, and sexual function after radical hysterectomy with pelvic lymphadenectomy for early-stage cervical cancer. Int J Gynecol Cancer, 16, 1119-29. https://doi.org/10.1111/j.1525-1438.2006.00461.x
  12. Park NY, Chong GO, Hong DG, Cho YL, Park IS, Lee YS et al (2011). Oncologic results and surgical morbidity of laparoscopic nerve-sparing radical hysterectomy in the treatment of FIGO stage IB cervical cancer: long-term follow-up. Int J Gynecol Cancer, 21, 355-62. https://doi.org/10.1097/IGC.0b013e31820731bb
  13. Papp Z, Csapo' Z, Hupuczi P, et al (2006). Nerve-sparing radical hysterectomy for stage IA2-IIB cervical cancer: 5-year survival of 501 consecutive cases. Eur J Gynecol Oncol, 27, 553-60.
  14. Park NY, Cho YL, Park IS, et al (2010). Laparoscopic pelvic anatomy of nerve-sparing radical hysterectomy. Clin Anat, 23, 186-91. https://doi.org/10.1002/ca.20915
  15. Possover M, Stober S, Plaul K, et al (2000). Identification and preservation of the motoric innervation of the bladder in radical hysterectomy type III. Gynecol Oncol, 79, 154-7 https://doi.org/10.1006/gyno.2000.5919
  16. Pieterse QD, Ter KuileMM, DeruiterMC, et al (2007). Vaginal blood flow after radical hysterectomy with and without nerve sparing. A preliminary report. Int J Gynecol Cancer.
  17. Querleu D, Morrow CP et al (2008). Classification of radical hysterectomy. Lancet Oncol, 9, 297-03. https://doi.org/10.1016/S1470-2045(08)70074-3
  18. Ramirez PT, Levenback C (2004). Radical trachelectomy: is it here to stay? Gynecol Oncol, 94, 611-3. https://doi.org/10.1016/j.ygyno.2004.07.031
  19. Raspagliesi F, Ditto A, Fontanelli R, et al (2004). Nerve-sparing radical hysterectomy: a surgical technique for preserving the autonomic hypogastric nerve. Gynecol Oncol, 93, 307-14. https://doi.org/10.1016/j.ygyno.2004.01.048
  20. Sakuragi N, Todo Y, Kudo M, et al. A systematic nerve-sparing radical hysterectomy technique in invasive cervical cancer for preserving postsurgical bladder function. Int J Gynecol Cancer, 15, 389-97.
  21. Selvaggi L, Loizzi V, Dl Gilio AR, et al (2006). Neoadjuvant chemo-therapy in cervical cancer: a 67 patients experience. Int J Gynecol Cancer, 16, 631-7. https://doi.org/10.1111/j.1525-1438.2006.00396.x
  22. Samlal RAK, Van der Velden J, Ketting BW, et al 1996). Diseasefree interval and recurrence pattern after the Okabayashi variant of Wertheim's radical hysterectomy for stage IB and IIA cervical carcinoma. Int J Gynecol Cancer, 6, 120-7. https://doi.org/10.1046/j.1525-1438.1996.06020120.x
  23. Sakuragi N, Todo Y, Kudo M, et al (2005). A systematic nervesparing radical hysterectomy technique in invasive cervical cancer for preserving postsurgical bladder function. Int J Gynecol Cancer, 15, 389-97. https://doi.org/10.1111/j.1525-1438.2005.15236.x
  24. Trimbos JB, Maas CP, Deruiter MC, et al (2001). A nerve-sparing radical hysterectomy: guidelines and feasibility in Western patients. Int J Gynecol Cancer, 11, 180-6. https://doi.org/10.1046/j.1525-1438.2001.01023.x
  25. Todo Y, Kuwabara M, Watari H, et al (2006). Urodynamic study on postsurgical bladder function in cervical cancer treated with systematic nerve-sparing radical hysterectomy. Int J Gynecol Cancer, 16, 369-75. https://doi.org/10.1111/j.1525-1438.2006.00345.x
  26. Trimbos JB, Maas CP, Deruiter MC, et al (2001). A nerve-sparing radical hysterectomy: guidelines and feasibility in Western patients. Int J Gynecol Cancer, 11, 180-6. https://doi.org/10.1046/j.1525-1438.2001.01023.x

Cited by

  1. Cavitron Ultrasonic Surgical Aspirator in Laparoscopic Nerve-Sparing Radical Hysterectomy vol.26, pp.3, 2016, https://doi.org/10.1097/IGC.0000000000000628
  2. The Effect of Targeted Therapy for Genitourinary Malignancies on Sexual Function and Fertility vol.18, pp.8, 2017, https://doi.org/10.1007/s11934-017-0704-9
  3. Efficacy and oncologic safety of nerve-sparing radical hysterectomy for cervical cancer: a randomized controlled trial vol.26, pp.2, 2015, https://doi.org/10.3802/jgo.2015.26.2.90