2022-RA-1469-ESGO Urological outcomes following nerve sparing radical hysterectomy for early stage cervical cancer

• Published in: International journal of gynecological cancer Vol. 32; no. Suppl 2; p. A61
• Main Authors: Raju K, VVN, Jonnada, Pavan Kumar, Keshri, Pradeep, Behera, Prasad, Usofi, Zeebha, Nusrath S, Syed
• Format: Journal Article
• Language: English
• Published: Oxford BMJ Publishing Group Ltd 20.10.2022; BMJ Publishing Group LTD
• Subjects: Bladder; Cervical cancer; Hysterectomy; Surgery
• ISSN: 1048-891X; 1525-1438
• DOI: 10.1136/ijgc-2022-ESGO.132

Introduction/BackgroundThe current study retrospectively analysed the functional, urological outcomes of nerve-sparing radical hysterectomy performed for early stage cervical cancer.MethodologyNerve sparing radical hysterectomy (NSRH) type C1 (Q-M) was performed on 42 patients included in this study. Bladder function was assessed symptomatically and objectively by ultrasonography, measuring post void residual urine volume (PVR) on 5th POD, at four and six weeks. The PVR of more than 100 ml on fifth post-operative day, more than 50 ml at four weeks after surgery was considered as bladder dysfunction.ResultsThe mean tumour size in our study is 2.1 cm with 73.8% were staged as IB (1–3). 66.7% (n=28) of nerve-sparing surgeries were performed laparoscopically and 33.3% (n=14) as open surgery with no conversion. First assessment on fifth POD revealed normal voiding pattern in 57.1% (n=24) of patients, 14.4% (n=6) had impaired sensation of fullness (sympathetic) and, 28.5% (n=12) had higher PVR (parasympathetic). The median PVR in our study was 88 ml by 5th POD. They were started on bladder training and reassessed four weeks later. By the end of 4 weeks after surgery, 90.5% (n=38) had normal voiding pattern and had sensation of fullness before voiding. However, 9.5% (n=4) had higher post void residual urinary volume and needed extended bladder training. The median post void residual urinary volume, one month after surgery was 37.5 ml. By the end of 6 months after surgery, all patients had complete sensation of bladder fullness and normal voiding pattern.ConclusionNSRH was significantly associated with decreased rates of urological dysfunction and is associated with improved quality of life of patients who underwent surgical treatment for early stage cervical cancer.