Radical Hysterectomy For Cervical Cancer Research Articles

Feasibility and safety of same-day discharge after laparoscopic radical hysterectomy for cervical cancer

Feasibility and safety of same-day discharge after laparoscopic radical hysterectomy for cervical cancer

Effects of repeated biaxial loads on the creep properties of cardinal ligaments

The cardinal ligament (CL) is one of the major pelvic ligaments providing structural support to the vagina/cervix/uterus complex. This ligament has been studied mainly with regards to its important function in the treatment of different diseases such as surgical repair for pelvic organ prolapse and radical hysterectomy for cervical cancer. However, the mechanical properties of the CL have not been fully determined, despite the important in vivo supportive role of this ligament within the pelvic floor. To advance our limited knowledge about the elastic and viscoelastic properties of the CL, we conducted three consecutive planar equi-biaxial tests on CL specimens isolated from swine. Specifically, the CL specimens were divided into three groups: specimens in group 1 (n = 7) were loaded equi-biaxially to 1 N, specimens in group 2 (n = 8) were loaded equi-biaxially to 2N, and specimens in group 3 (n = 7) were loaded equi-biaxially to 3N. In each group, the equi-biaxial loads of 1N, 2N, or 3N were applied and kept constant for 1200s three times. The two axial loading directions were selected to be the main in-vivo loading direction of the CL and the direction that is perpendicular to it. Using the digital image correlation (DIC) method, the in-plane Lagrangian strains in these two loading directions were measured throughout the tests. The results showed that CL was elastically anisotropic, as statistical differences were found between the mean strains along the two axial loading directions for specimens in group 1, 2, or 3 when the equi-biaxial load reached 1N, 2N, or 3N, respectively. For specimens in group 1 and 2, no statistical differences were detected in the mean normalized strains (or, equivalently, the increase in strain over time) between the two axial loading directions for each creep test. For specimens in group 3, some differences were noted but, by the end of the 3rd creep test, there were no statistical differences in the mean normalized strains between the two axial loading directions. These findings indicated that the increase in strain over time by the end of the 3rd creep test were comparable along these directions. The greatest mean normalized strain (or, equivalently, the largest increase in strain over time) was measured at the end of the 1st creep test (t=1200s), regardless of the equi-biaxial load magnitude or loading direction. Mean normalized strains during the 2nd and 3rd creep tests (t = 100, 600, and 1200s), along each loading direction, were not statistically different. Isochronal data collected at 1N, 2N, or 3N equi-biaxial loads indicated that the CL may be a nonlinear viscoelastic material. Overall, this experimental study offers new knowledge of the mechanical properties of the CL that can guide the development of better treatment methods such as surgical reconstruction for pelvic organ prolapse and radical hysterectomy for cervical cancer.

Comparative effectiveness of laparoscopic radical hysterectomy for cervical cancer.

e17015 Background: Despite the benefits of minimally invasive surgery for cervical cancer, population-level data describing the surgery’s effectiveness in unselected patients are lacking. We compared morbidity, cost, and survival between abdominal radical hysterectomy and laparoscopic radical hysterectomy for cervical cancer. Methods: We used the Korean Health Insurance Review and Assessment Service database to identify women with cervical cancer who underwent radical hysterectomy from 2011 to 2014. Patient who underwent abdominal radical hysterectomy were compared with those who had minimally invasive hysterectomy. Perioperative morbidity, use of adjuvant therapy, and survival were evaluated. Results: We identified 6,335 patients including 3,235 who underwent abdominal radical hysterectomy and 3,100 who underwent laparoscopic radical hysterectomy. Uptake of laparoscopic radical hysterectomy increased from 46.1% in 2011 to 51.8% in 2014. Patients who were younger and treated at larger hospital were more likely to undergo laparoscopic procedure (P<0.001). Laparoscopic radical hysterectomy had lower rates of complication, less transfusion requirement, shorter hospital stays, and reduced total medical costs (P<0.001). There was no significant association between use of laparoscopic approach and recurrence-free survival (P=0.194). Conclusions: Laparoscopic radical hysterectomy was associated with lower risk of perioperative complication and have comparable outcomes with abdominal radical hysterectomy.

Surgical outcomes of single port lapraroscopic radical hysterectomy in cervical cancer.

e17003 Background: We aim to see the postoperative outcomes of single port laparoscopic radical hysterectomy in cervical cancer. Methods: Twenty five cervical cancer patients (FIGO stage 9 IA, 13 IB, and 3 IIA) were treated by single port laparoscopic radical hysterectomy in single center. Results: Six patients were performed by type A hysterectomy, 6 by type B, and 13 by type C radical hysterectomy. Median operation time was 91, 197, and 275 minutes, respectively. Median number of pelvic nodes retrieved was 20. There was no postoperative complication except a colon serosa injury in type C radical hysterectomy and which repaired by single port approach. Ten out of 25 patients got an adjuvant radiation therapy and there were 3 recurrences (1 in type A, 2 in type C). Median disease free survival was 9.5 months in type A, 14 months in type C. Conclusions: Single port radical hysterectomy is safe and comparable to conventional laparoscopic hysterectomy in cervical cancer

Cost analysis of minimally invasive radical hysterectomy for cervical cancer performed by a single surgeon in an Italian center: an update in gynecologic oncological field.

The objective of this study is to perform an economic analysis and examine the influence of procedural volume of our hospital, evaluating the accounting systems of Robotic radical hysterectomy (RRH) vs Laparoscopic radical hysterectomy (TLRH) in patients with cervical carcinoma, due to the costs widely variable and lack in literature. Costs were collected prospectively, from March 2010 to March 2016. Direct costs were determined by examining the overall medical pathway for each type of intervention. 52 patients with cervical carcinoma, which were matched by age, body mass index, tumor size, International Federation of Gynecology and Obstetrics (FIGO) stage, comorbidity, previous neoadjuvant chemotherapy, histology type, and tumor grade to obtain homogeneous samples. Surgical time was similar for both the groups. RRH was associated with a significantly less (EBL) estimated blood loss (P=0.000). The overall median length of follow-up was of 59months. The cost of the robot-specific supplies was €2705 per intervention. When considering overall medical surgical care, the patient treatment average cost of an RRH was €5650,31 with an hospital stay (HS) of 3.58days (SD±1) vs €3750.86 for TRLH, with an HS of 4.27days (SD±1.79). Our results are similar to Finnish data; the costs of robot-assisted hysterectomies were 1.5 times higher than TLRH. The main drivers of additional costs are robotic disposable instruments, which are not compensated by the hospital room costs and by an experienced team staff. Implementation of strategies to reduce the cost of robotic instrumentation is due. RRH resulted less expensive than robotic simple hysterectomy for benign conditions.

Role of pelvic and para-aortic lymphadenectomy in abandoned radical hysterectomy in cervical cancer

BackgroundCervical cancer (CC) occupies fourth place in cancer incidence and mortality worldwide in women, with 560,505 new cases and 284,923 deaths per year. Approximately, nine of every ten (87%) take place in developing countries. When a macroscopic nodal involvement is discovered during a radical hysterectomy (RH), there is controversy in the literature between resect macroscopic lymph node compromise or abandonment of the surgery and sending the patient for standard chemo-radiotherapy treatment. The objective of this study is to compare the prognosis of patients with CC whom RH was abandoned and bilateral pelvic lymphadenectomy and para-aortic lymphadenectomy was performed with that of patients who were only biopsied or with removal of a suspicious lymph node, treated with concomitant radiotherapy/chemotherapy in the standard manner.MethodsA descriptive and retrospective study was conducted in two institutions from Mexico and Colombia. Clinical records of patients with early-stage CC programmed for RH with an intraoperative finding of pelvic lymph, para-aortic nodes, or any extracervical involvement that contraindicates the continuation of surgery were obtained. Between January 2007 and December 2012, 42 clinical patients complied with study inclusion criteria and were selected for analysis.ResultsIn patients with CC whom RH was abandoned due to lymph node affectation, there is no difference in overall survival or in disease-free period between systematic lymphadenectomy and tumor removal or lymph node biopsy, in pelvic lymph nodes as well as in para-aortic lymph nodes, when these patients receive adjuvant treatment with concomitant radiotherapy/chemotherapy.ConclusionsThis is a hypothesis-generator study; thus, the recommendation is made to conduct randomized prospective studies to procure better knowledge on the impact of bilateral pelvic and para-aortic lymphadenectomy on this group of patients.

中西医结合改善宫颈癌根治术后膀胱功能效果评价

目的：观察针灸治疗配合口服盐酸坦洛新改善宫颈癌根治术后膀胱功能的效果。方法：收集2014年6月至2017年4月在我院接受宫颈癌根治术的患者共41例，其中22例患者在术后留置尿管2~3周后直接拔除；另外19例患者在拔除尿管前给予针灸治疗及口服盐酸坦洛新，拔管后观察两组患者在安置尿管时间、膀胱残余尿量、尿路感染及尿潴留发生情况。结果：两组患者在安置尿管时间、膀胱残余尿量、尿路感染率及尿潴留发生率方面均有统计学差异，P值 < 0.05，治疗组优于对照组。结论：中西医结合治疗能明显促进宫颈癌根治术后患者膀胱机能的恢复，缩短患者的尿管安置时间，减少尿潴留，降低尿路感染的发生率。 Objective: To observe acupuncture and Oral Tamsulosin Hydrochloride Sustained-release Capsules improving the urinary function after radical hysterectomy for cervical cancer. Methods: Clinical data of 41 cases which accepted radical hysterectomy from June 2014 to April 2017 in our hospital were collected; there were22 cases extracted ureter directly after 2 - 3 weeks in the control group. The rest of 19 cases were been given acupuncture and Oral Tamsulosin Hydrochloride Sustained-release Capsules before extracting ureter in the treatment group. And then compare ureter time, the residual urine volume, urinary tract infection and urinary retention in two groups. Results: There are the significant differences (P < 0.05) of ureter time, the residual urine volume, urinary tract infection and urinary retention in two groups. The efficacy in the treatment group was better than that in the control group. Conclusion: Integration of Chinese and Western Medicine can improve definitely the efficacy on urinary retention after radical hysterectomy for cervical cancer, shortening ureter times, reducing urinary retention and urinary infection.

Staging Issues in Cervical Cancer

Background: Worldwide cervical cancer is third most common cancer, but diagnostic, therapeutic problems continue in developing countries where it is most common cancer in women. Very few women report at operable stage. For those subjected to surgery, intraoperative findings, histopathology provides information for continuing or abandoning surgery, adjuvant therapy after surgery and so on. However clinical investigative staging may not be correct, leading to avoidable morbidity of surgery. Objective: Study was done to know relationship between clinical, intraoperative, postoperative staging in women who underwent surgery for cervical cancer. Material methods: Analysis duration was divided into 4 yearly 7 blocks. During study period 266 women underwent abdominal radical hysterectomy, 15 were for endometrial cancer so, 251 (94.36% radical hysterectomies for cervical cancer, 13.05% of all cervical cancers cases (stage I A, I B1, II A1) were study subjects. Results: Cervical cancer cases increased over the years and also operable cases of cervical cancer from 13.33% to 30.00%. However of 251cases taken for surgery, 28% would not have been for surgery if were known to be of stage which was found intraoperative (preoperative under staging), over staging was only in 2%. Correlating clinical, histopathological staging 36% would not have been for surgery if correct staging (after histopathology) was known pre-operatively. Clinical intraoperative staging had 72% agreement. Histopathological staging which helps in planning treatment agreed with clinical staging in 64%. Problem of under staging continued over years. Conclusion: With present day techniques available to women with low resources, there is a lot of under staging of cervical cancer cases which leads to unnecessary surgery. Low cost modalities for better evaluation of cases preoperatively and will help in reducing morbidity, save resources also.

Minimally Invasive Radical Hysterectomy for Cervical Cancer Is Associated With Reduced Morbidity and Similar Survival Outcomes Compared With Laparotomy

Study ObjectiveTo assess outcomes of women with cervical cancer undergoing upfront radical hysterectomy (RH) via a minimally invasive surgery (MIS) or a traditional laparotomy (XL) approach at 2 large US academic institutions to determine whether the mode of surgery affects patient outcomes. DesignRetrospective cohort study (Canadian Task Force classification II-1). SettingTwo academic medical institutions in the United States. PatientsWomen undergoing upfront RH for cervical cancer between 2000 and 2013. InterventionMinimally invasive techniques (laparoscopic and robotic) for RH compared with XL. Measurements and Main ResultsA total of 383 women met the eligibility requirements. Of these, 101 underwent an MIS (i.e., traditional laparoscopy, laparoendoscopic single site, or robotic) approach, and 282 underwent an XL approach. Overall survival (median not reached; p = .29) was not different between the 2 groups. Recurrence was rare and equivalent in the 2 groups, affecting 5.0% of patients in the MIS group and 6.4% of those in the XL group (p = .86). Pelvic lymph nodes were dissected in 98% of patients in the MIS group and 97% of those in the XL group (p > .99) and were found to be positive in 10.9% and 8.5% of those patients, respectively (p = .55). The mean number of pelvic lymph nodes retrieved was higher in the MIS group (19.4 vs 16.0; p < .001). There was no between-group difference in the rate of postoperative chemotherapy (p = .32) or radiation therapy (p = .28). Surgical margins were positive in 5.0% of specimens in the MIS group and in 4.6% of specimens in the XL group (p = .54). Although there was no difference in the overall rate of complications (15.1% and 17.2%, respectively; p = .87), laparotomy was associated with a higher median estimated blood loss (EBL) (50 cm3 vs 500 cm3) and a higher rate of perioperative blood transfusion (3.0% vs 26.2%; p < .001). Length of perioperative hospital stay was significantly shorter in the MIS group (1.9 days vs 4.9 days; p < .001). ConclusionMIS RH does not compromise patient outcomes, including overall survival, rate of recurrence, and the frequency of pelvic lymph node dissection or positivity. Morbidity was decreased in the MIS group, including decreased EBL, fewer blood transfusions, and shorter hospital stay.

Effects of propofol and sevoflurane on perioperative immune response in patients undergoing laparoscopic radical hysterectomy for cervical cancer.

The aim of this study is to compare the effects of propofol and sevoflurane anesthesia on perioperative immune response in patients undergoing laparoscopic radical hysterectomy for cervical cancer.Sixty patients with cervical cancer scheduled for elective laparoscopic radical hysterectomy under general anesthesia were randomized into 2 groups. TIVA group received propofol induction and maintenance and SEVO group received sevoflurane induction and maintenance. Blood samples were collected at 30 min before induction (T0); the end of the operation (T1); and 24 h (T2), 48 h (T3), and 72 h (T4) after operation. The T lymphocyte subsets (including CD3+ cells, CD4+ cells, and CD8+ cells) and CD4+/CD8+ ratio, natural killer (NK) cells, and B lymphocytes were analyzed by flow cytometry.After surgery, all immunological indicators except CD8+ cells were significantly decreased in both groups compared to basal levels in T0, and the counts of CD3+ cells, CD4+ cells, NK cells, and the CD4+/CD8+ ratios were significantly lower in the SEVO groups than that in the TIVA group. However, the numbers of B cells were comparable at all the time points between 2 groups.Laparoscopic radical hysterectomy for cervical cancer is associated with postoperative lymphopenia. In terms of protecting circulating lymphocytes, propofol is superior to sevoflurane.

Laparoscopic Robotic Radical Hysterectomy in an Adult with Congenital Heart Disease: A Case Report and Review of the Literature

Purpose : Non-cardiac surgeries in adults with congenital heart disease are increasing due to improved survival of children with congenital heart disease. There has also been an increase in laparoscopic procedures due to benefits including decreased length of stay and improved quality of life. There have been concerns regarding laparoscopic surgery in patients with congenital heart disease especially with pneumoperitoneum and positioning related to hemodynamic effects. We present a case of laparoscopic surgery in an adult with congenital heart disease who underwent robotic radical hysterectomy and provide a review of the literature. Methods/Results : The case of a 39 year old female with palliated congenital heart disease who underwent laparoscopic robotic radical hysterectomy for cervical cancer was summarized. A review of the literature was performed. Ten surgeries in 9 adult patients were reported with good outcomes. Insufflation pressures were reported in 8 of 10 surgeries and kept at or below 15 mmHg. Conclusions : When performed in centers with experience in CHD, non-cardiac laparoscopic surgery has been shown to be safe and effective. CO 2 abdominal insufflation pressures should be reduced as much as possible without compromising visualization, in order to decrease potential negative effects on hemodynamics.

Does the Robotic Platform Reduce Morbidity Associated With Combined Radical Surgery and Adjuvant Radiation for Early Cervical Cancers?

Open radical hysterectomy followed by adjuvant radiation for cervical cancer has been associated with significant rates of morbidity. Radical hysterectomy is now often performed robotically. We sought to examine if the robotic platform decreased the morbidity associated with radical hysterectomy followed by adjuvant radiation. A retrospective cohort of patients with cervical cancer undergoing radical hysterectomy from 1995 to 2013 was evaluated. Complications were assessed using electronic record review and graded. χ tests and Student t tests were used for analysis. Overall, 243 patients underwent radical hysterectomy for cervical cancer. Surgical approach was 43% open and 57% robotic. Eighty-three patients (34.2%) required adjuvant radiation. Overall, radical hysterectomy plus adjuvant radiation was associated with increased risk of complication (29%) compared to radical hysterectomy alone (7%) (P < 0.001). Complications included lymphedema (n = 18), bowel-associated complications (n = 10), and urinary complications (n = 7). There was no difference in time to initiation of radiation between open and robotic surgery (43 vs 47 days; P = 0.33). There was no difference in grade 2/3 complications in patients receiving adjuvant radiation between open and robotic surgery (27.5% vs 27.9%; P = 0.97). Patients undergoing open surgery followed by radiation experienced a trend toward increased adhesion-related complications, such as bowel obstruction and ureteral stricture (10% vs 2.3%; P = 0.19); whereas patients undergoing robotic surgery followed by radiation experienced a trend toward increased lymphedema (19% vs 8%; P = 0.20). We found no difference in long-term complications between patients who underwent robotic surgery compared to open radical hysterectomy with adjuvant radiation. There may be fewer adhesion-related complications with robotic surgery. However, as many radiation-related complications occur at later time points, continued follow-up to evaluate for potential differences between the 2 groups is necessary.

Preoperative intrinsic factors affecting voiding recovery after radical hysterectomy for cervical cancer

Preoperative intrinsic factors affecting voiding recovery after radical hysterectomy for cervical cancer

Minimally invasive radical hysterectomy for cervical cancer reduces morbidity with similar outcomes compared with laparotomy

Minimally invasive radical hysterectomy for cervical cancer reduces morbidity with similar outcomes compared with laparotomy

Cavitron Ultrasonic Surgical Aspirator in Laparoscopic Nerve-Sparing Radical Hysterectomy: A Pilot Study.

ObjectivePelvic autonomic nerve preservation during radical hysterectomy for cervical cancer has become a priority in recent years. This pilot study was undertaken to evaluate laparoscopic nerve-sparing radical hysterectomy (L-NSRH) using the Cavitron Ultrasonic Surgical Aspirator (CUSA) in women with cervical cancer.MethodsPatients with stage IB1 or IIA1 cervical cancer underwent L-NSRH with pelvic lymphadenectomy. The patients were randomly assigned to receive L-NSRH using a CUSA (CUSA group; n = 24) or using other techniques (non-CUSA group; n = 21). Recovery of bladder function (indwelling catheter time and time to spontaneous voiding) blood loss, duration of hospital stay, lymph node harvesting, and postoperative complications were compared between the 2 groups. Patients were followed for up to 3 years to determine the maintenance of effect.ResultsAll patients underwent L-NSRH successfully. Intraoperative blood loss was significantly less in the CUSA than in the non-CUSA group (P = 0.005). Length of hospital stay (P = 0.006) and indwelling catheter time (P = 0.008) were both significantly reduced in the CUSA group compared with that in the non-CUSA group. The spontaneous voiding rate 10 days postoperatively was 95.8% with CUSA and 85.7% with non-CUSA techniques. Two patients developed postoperative complications in the CUSA group as did 3 patients in the non-CUSA group. These were cases of lymphocyst formation or urinary tract infection.ConclusionsLaparoscopic nerve-sparing radical hysterectomy using CUSA was safe and feasible in patients with cervical cancer. Our results provide initial evidence that L-NSRH using CUSA preserves pelvic autonomic nerve function.

Frequency, Intensity and Daily Life Distress of Urinary Dysfunction in Women with Cervical Cancer after Radical Hysterectomy

This study was done to identify frequency, intensity of urinary dysfunction and daily life distress in women after a radical hysterectomy for cervical cancer. One hundred and fifty seven women who had undergone a radical hysterectomy and one hundred and sixty five women as healthy controls completed questionnaires on intensity of urinary dysfunction and daily life distress caused by urinary dysfunction. Women with cervical cancer showed higher frequency of urinary dysfunction than healthy controls. Major urinary dysfunction for women with cervical cancer in order of frequency were night-time incontinence (odds ratio=10.39, p<.001), difficulty in starting urination, weak urine stream and sense of incomplete emptying of bladder. The highest score on intensity was difficulty in starting urination, followed by urgency, weak urine stream, daytime frequency and sense of incomplete emptying. Night-time incontinence was the urinary symptom causing the most daily life distress for cervical cancer women followed by difficulty in starting urination, urgency, sense of incomplete emptying, and night-time frequency. Results suggest that nurses should address the potential postoperative urinary complications and develop long term interventions to decrease urinary dysfunction and daily life distress for women who have had a radical hysterectomy for cervical cancer.

Prognostic and Safety Roles in Laparoscopic Versus Abdominal Radical Hysterectomy in Cervical Cancer: A Meta-analysis.

Objective: Studies comparing the prognostic results between laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) in cervical cancer reported contradictory results. We aimed to evaluate the prognostic and safety roles of LRH by pooling studies in a meta-analysis.Materials and Methods: Original articles were searched in PubMed, EMBASE, and the Cochrane Library. The survival results (5-year disease-free survival [DFS], 5-year overall survival [OS], and recurrence rate [RR]), safety parameters (intra-, peri-, and postoperative complication rates and postoperative bowel or bladder recovery days), efficiency parameters (pelvic/para-aortic lymph nodes removed), and other parameters (operative time, estimated blood loss, and hospital of stay) between the two approaches were reviewed.Results: For the 2922 cases identified, DFS, OS, and RR did not differ in balanced prognostic factors, including lymph node metastasis, Stage IIB or above, non–squamous cancer histology, grade G3, lymphovascular space invasion, tumor size ≥4 cm, and positive parametrial and vaginal margin rates. Meanwhile, LRH was associated with higher complication rates and a shorter time to the recovery of bowel or bladder function than for ARH. The number of removed pelvic or para-aortic lymph nodes did not significantly differ. Other parameters showed LRH was associated with a longer operative time, less blood loss, and a shorter length of hospital stay. The survival and prognostic results did not differ in balanced prognostic factors.Conclusions: LRH is safe and has lower operative complication rates than ARH.

A Detailed Analysis of the Learning Curve: Da Vinci Robot-Assisted Radical Hysterectomy in Cervical Cancer

A Detailed Analysis of the Learning Curve: Da Vinci Robot-Assisted Radical Hysterectomy in Cervical Cancer

A Simple Laparoscopic Procedure to Restore a Normal Vaginal Length After Colpohysterectomy With Large Upper Colpectomy for Cervical and/or Vaginal Neoplasia

Colpohysterectomy is sometimes associated with a large upper colpectomy resulting in a shortened vagina, potentially impacting sexual function. We report on a preliminary experience of a laparoscopic colpoplasty to restore a normal vaginal length. Patients with shortened vaginas after a laparoscopic colpohysterectomy were considered for a laparoscopic modified Davydov's procedure to create a new vaginal vault using the peritoneum of the rectum and bladder. From 2010 to 2014, 8 patients were offered this procedure, after informed preoperative consent. Indications were 2 extensive recurrent vaginal intraepithelial neoplasias grade 3 and 6 radical hysterectomies for cervical cancer. Mean vaginal length before surgery was 3.8 cm (standard deviation, 1.6). Median operative time was 50 minutes (range, 45–90). Blood loss was minimal (50–100 mL). No perioperative complications occurred. Median vaginal length at discharge was 11.3 cm (range, 9–13). Sexual intercourse could be resumed around 10 weeks after surgery. At a median follow-up of 33.8 months (range, 2.4–51.3), 6 patients remained sexually active but 2 had stopped. Although this experience is small, this laparoscopic modified Davydov's procedure seems to be an effective procedure, adaptable to each patient's anatomy. If the initial postoperative regular self-dilatation is carefully observed, vaginal patency is durably restored and enables normal sexual function.

Urinary and anal dysfunction after laparoscopic versus laparotomic radical hysterectomy

ObjectiveThe aim of this study was to compare urinary and anal dysfunction after laparoscopic (LRH) and abdominal (ARH) radical hysterectomy for cervical cancer. Study designConsecutive patients who underwent radical hysterectomy for treatment of cervical cancer were enrolled in this study and divided into two groups, according to the surgical approach. Urinary and anal symptoms were evaluated before and 6 months after surgery. ResultsFifty-four women were considered: 27 LRH and 27 ARH. Urinary incontinence was significantly more frequent both after LRH (37% vs 86.9%, p=0.0004) and after ARH (33.3% vs 100%, p<0.0001); urge incontinence (3.7% vs 29.6%, p=0.02) and increased bladder sensation (0 vs 22.2%, p=0.02) were significantly more common postoperatively in patients undergone ARH. In both groups more patients complain about increase of straining during voiding (LRH: 0 vs 34.7%, p=0.009; ARH: 3.7% vs 29.6% p=0.02) after surgery. Postoperative constipation by obstructed defecation was more frequent after ARH (Wexner score: 0 vs 2, p=0.03) but not after LRH. ConclusionFrom our results, laparoscopic approach for radical hysterectomy seems to reduce the postoperative occurrence of urge incontinence, increased bladder sensation and constipation by obstructed defecation, in comparison with abdominal radical surgery.