title: A prospective study of nerve-sparing radical hysterectomy for uterine cervical carcinoma in Taiwan.
abstract: OBJECTIVE
  Surgical therapy for cervical carcinoma carries a significant risk of functional impairment to the bladder. This study evaluates the feasibility and complications of nerve-sparing radical hysterectomy (NRH) in Taiwan.
  
  
  METHODS
  Between March 2010 and March 2011, consecutive patients diagnosed with early stage cervical cancer (FIGO stage Ia2 to Ib1) and tumor size < 3 cm were recruited prospectively to undergo NRH or conventional radical hysterectomy (RH). Patients with histories of urinary stress incontinence or bladder dysfunction disease were excluded. A modified Tokyo nerve-sparing radical hysterectomy was performed.
  
  
  RESULTS
  A total of 30 patients were enrolled. Among these, 18 patients underwent NRH with successful bilaterally nerve-sparing procedures in 15 cases (83%), unilaterally nerve-sparing procedures in 2 cases (11%), and a failure in 1 case (6%). The indwelling catheter was removed on postoperative day 6. The mean±SD duration from operation to spontaneous voiding was 6.8 ± 1.5 days for women who underwent NRH; the corresponding duration for women who underwent RH or failed NRH was 20.6 ± 3 days. None of the patients who underwent NRH required intermittent catheterization. All 12 patients who underwent RH needed self-catheterization after discharge. There was a significant reduction in the incidence of postoperative self-catheterization (p<0.01) and bladder dysfunction (p<0.006). Average satisfaction score analyzed by the Likert-scale questionnaire was 4.5 for the NRH group and 1.9 for RH group (p<0.0001).
  
  
  CONCLUSIONS
  We concluded that the new technique of NRH can reduce postoperative bladder dysfunctions.
authors.affiliation: Department of Obstetrics and Gynecology, Chung Shang Medical University Hospital, Taiwan. tsengcj@gmail.com
authors.forename: Chih-Jen
authors.initials: CJ
authors.lastname: Tseng
authors.forename: Huang-Pin
authors.initials: HP
authors.lastname: Shen
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Lin
authors.forename: Chung-Yuan
authors.initials: CY
authors.lastname: Lee
authors.forename: Will
authors.initials: W
authors.lastname: Wei-Cheng Chiu
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D059351:Organ Sparing Treatments; D017060:Patient Satisfaction; D059348:Peripheral Nerve Injuries / Q000150:complications / Q000517:prevention & control*; D020127:Recovery of Function; D018709:Statistics, Nonparametric; D013624:Taiwan; D013997:Time Factors; D001743:Urinary Bladder / Q000294:innervation* / Q000503:physiopathology; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000209:etiology / Q000628:therapy; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*