Type II versus Type III nerve-sparing radical hysterectomy: comparison of lower urinary tract dysfunctions.
OBJECTIVE
According to our previous experience, Type III Nerve-sparing Radical hysterectomy (NSRH) for cervical cancer presented an acceptable urologic morbidity, without compromising radicality. The aim of this study was to compare Type NSRH with other types of RH in terms of incidence of early bladder dysfunctions and perioperative complications.


METHODS
One hundred and ten patients with cervical cancer were submitted to Type II RH (group 1), Type III NSRH (group 2) and Type III RH (group 3). We assessed the postoperative early bladder function and complications. The follow-up period was 3 months.


RESULTS
Group 1 had a significantly shorter duration of the surgery, minor mean blood loss and shorter mean length of postoperative stay when compared to groups 2 and 3. No intraoperative complications were reported in either of the groups. The groups did not differ significantly in terms of GIII/IV morbidity (group 1 = 10%, group 2 = 10% and group 3 = 15%, chi(2), P value: 0.65). Not even they differed in terms of urologic GI-IV morbidity (group 1 = 13%, group 2 = 15% and group 3 = 10%, chi(2), P value = 0.88). Groups 1 and 2 presented a prompt recover of bladder function, significantly different from that of group 3. There was a significant difference between the groups regarding the number of patients discharged with self-catheterism (group 1 = 0; group 2 and group 3 = 11; chi(2), P value << 0.05).


CONCLUSIONS
The Type III NSRH seems to be comparable to Type II RH and superior to Type III RH in terms of early bladder dysfunctions.
Raspagliesi
Francesco
F
Department of Gynecologic Oncology, Istituto Nazionale Tumori, via Venezian 1, 20133 Milan, Italy.
Ditto
Antonino
A
Fontanelli
Rosanna
R
Zanaboni
Flavia
F
Solima
Eugenio
E
Spatti
Gianbattista
G
Hanozet
Francesco
F
Vecchione
Francesca
F
Rossi
Gabriella
G
Kusamura
Shigeki
S
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D001743:Urinary Bladder / Q000294:innervation / Q000503:physiopathology; D001745:Urinary Bladder Diseases / Q000209:etiology* / Q000503:physiopathology; D002583:Uterine Cervical Neoplasms / Q000601:surgery*; D014599:Uterus / Q000276:immunology