title: Self-assessment of morbidity following radical hysterectomy for cervical cancer.
abstract: The aim of this study was to assess the magnitude of the morbidity following radical surgery for early stage cervical cancer. We performed a retrospective survey of all women who had undergone a radical hysterectomy and lymphadenectomy between the months of July 1995 and December 1996 inclusive at either the Royal Marsden or St George's Hospital (n =38), using a detailed questionnaire on bladder, ano-rectal and sexual function, both before and after treatment. Sixteen women (44.4%) received adjuvant radiotherapy. The mean interval between surgery and inquiry was 16.4% months (range 8-25 months). The mean age at the time of surgery was 40.5 years. Thirty-six out of 38 women contacted responded (94.7%). Overall 33 women (91.7%) reported new bladder, ano-rectal or sexual symptoms. Complaints of urinary incontinence, particularly of urge incontinence, and of voiding difficulties increased significantly after surgery (P <0.05). However, only 5.3% of women had sought treatment. Tenesmus increased significantly (P <0.05), while increases in diarrhoea and faecal incontinence were not statistically significant (P =0.051). Although 12.9% of women stated an improvement in their sex lives, 54.8% thought that their sex life was worse after treatment, and 12.9% of women had ceased sexual activity altogether. Of women of childbearing age 53.8% felt adversely affected by their loss of fertility. Bladder, ano-rectal and sexual symptoms are very common following radical hysterectomy for cervical cancer, with adverse effect on quality of life, and persist into the second year after treatment.
authors.affiliation: The Royal Marsden Hospital, London, UK.
authors.forename: S A
authors.initials: SA
authors.lastname: Butler-Manuel
authors.forename: K
authors.initials: K
authors.lastname: Summerville
authors.forename: A
authors.initials: A
authors.lastname: Ford
authors.forename: P
authors.initials: P
authors.lastname: Blake
authors.forename: A J
authors.initials: AJ
authors.lastname: Riley
authors.forename: A H
authors.initials: AH
authors.lastname: Sultan
authors.forename: A K
authors.initials: AK
authors.lastname: Monga
authors.forename: S L
authors.initials: SL
authors.lastname: Stanton
authors.forename: J H
authors.initials: JH
authors.lastname: Shepherd
authors.forename: D P
authors.initials: DP
authors.lastname: Barton