Effect of laparoscopic nerve sparing radical hysterectomy on bladder function

Abstract

Objective To compare the urodynamic indexes in patients undergoing laparoscopic nerve sparing radical hysterectomy vs conventional radical hysterectomy. Methods The clinical data of 64 patients with early stage cervical cancer or stage Ⅱ endometrial carcinoma, who underwent surgical treatment in the Department of Gynecologic Oncology, Xinxiang Municipal Central Hospital between August 2013 and October 2015, were retrospectively analyzed. According to different surgical methods, all patients were divided into two groups. Group A (n=30) underwent laparoscopic nerve sparing radical hysterectomy and pelvic lymphadenectomy. Group B (n=34) underwent conventional radical hysterectomy and pelvic lymphadenectomy. The urodynamics and color ultrasonography of residual urine volume were compared between the two groups. Results In the both groups, the maximum urinary bladder capacity, maximum flow rate and detrusor pressure at maximum urinary flow rate after the operation significantly decreased compared with baseline. The maximum urinary bladder capacity significantly increased, and the maximum flow rate and detrusor pressure at maximum urinary flow rate decreased in the conventional radical hysterectomy group compared with those in the laparoscopic nerve sparing radical hysterectomy group (P<0.05) . The maximum urinary bladder capacity and the findings of residual urine volume in the laparoscopic nerve sparing radical hysterectomy group were more favorable than those in the conventional radical hysterectomy group. Conclusion Laparoscopic nerve sparing radical hysterectomy shows less interference with lower urinary tract function, which is more beneficial to the recovery of bladder function than the conventional method. Key words: Laparoscopy; Pelvic autonomic nerve; Radical hysterectomy; Urodynamics