Quality of life and sexual, bladder, and intestinal dysfunctions after class III nerve-sparing and class II radical hysterectomies: a questionnaire-based study.
BACKGROUND
To compare quality of life and bladder, intestinal, and sexual dysfunctions in 2 groups of patients undergoing different types of radical hysterectomies (RHs).


METHODS
Patients with cervical cancer who underwent RH have been enrolled in a questionnaire-based study. Quality of life (QoL) and bladder, intestinal, and sexual dysfunctions were evaluated with the Functional Assessment of Cancer Therapy-Cervix (FACT-Cx). Patients were grouped according to the type of RH: group 1, class II RH and group 2, class III nerve-sparing RH (NSRH).


RESULTS
Of 157 women included in the study, 127 filled out the questionnaire. Overall, QoL score assessed with the FACT questionnaire did not differ significantly between the 2 groups. The FACT subscales assessing physical, functional, emotional, and social well-being did not differ significantly between the 2 groups, whereas the FACT-Cx subscales assessing disease-related symptoms in group 2 patients showed a significantly worse score (72 vs 66; P = 0.03). Evaluating singularly the 15 items of the Cx subscales assessing disease-related symptoms, we did not find any significant difference between the 2 groups, but only Cx1 ("I am bothered by discharge or bleeding from my vagina") was significantly worse in group 2 patients. At univariate analysis, we found that NSRH and adjuvant radiotherapy (RT) impact negatively on the FACT-Cx subscales regarding pelvic visceral function. However, at multivariate analysis, only adjuvant RT impact negatively.


CONCLUSIONS
Patients submitted to class III NSRH did not present worse QoL and pelvic visceral dysfunctions when compared with class II RH. The RT seems to be a factor impacting negatively on bladder and sexual function.
Ditto
Antonino
A
Department of Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. antonino.ditto@istitutotumori.mi.it.
Martinelli
Fabio
F
Borreani
Claudia
C
Kusamura
Shigeki
S
Hanozet
Francesco
F
Brunelli
Cinzia
C
Rossi
Gabriela
G
Solima
Eugenio
E
Fontanelli
Rosanna
R
Zanaboni
Flavia
F
Grijuela
Barbara
B
Raspagliesi
Francesco
F
D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007410:Intestinal Diseases / Q000175:diagnosis / Q000209:etiology*; D008875:Middle Aged; D011183:Postoperative Complications; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000209:etiology*; D011795:Surveys and Questionnaires; D001745:Urinary Bladder Diseases / Q000175:diagnosis / Q000209:etiology*; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy / Q000601:surgery*