Urinary tract morbidity after nerve-sparing radical hysterectomy in women with cervical cancer

Abstract

Nerve-sparing radical hysterectomy (NSRH) has been developed as a method of cervical cancer treatment to reduce surgical morbidity compared with radical abdominal hysterectomy. The aim of this study was to analyze the short- and long-term effects of NSRH on urinary tract function. A study group of 117 patients underwent NSRH type C1 with pelvic lymphadenectomy for cervical cancer stages IB1-IB2 without adjuvant radiotherapy at our department. A total of 106 patients aged 21-74years (mean age 44.8) were available for follow-up at 1year after surgery. A transurethral catheter was left in place for 48h after surgery, and the postvoid residual (PVR) volume was measured after its removal. One week before surgery and 12months after NSRH, lower urinary tract function was evaluated by an urodynamic examination. Five days after surgery, the PVR volume was greater than 100ml in 5 patients (4.7%) and a suprapubic catheter was inserted into these women for bladder training over the following days. Within 14days after surgery, urination without PVR was achieved in all women who underwent surgery. Postoperatively, a slight increase in the average maximum bladder cystometric capacity was recorded from 420 to 445ml (p value 0.009) without prolonging the voiding time. Other urodynamic parameters were not significantly different before and 12months after NSRH. In this series, NSRH preserved voiding function and bladder sensation at 1year and did not appear to compromise oncological outcome.