title: A Modified Nerve-Sparing Panhysterectomy for Benign Uterine Diseases: Techniques and Evaluation of Postoperative Pelvic Dysfunctions.
abstract: OBJECTIVE
  To describe a modified nerve-sparing panhysterectomy and to investigate the feasibility and impact of this nerve-sparing technique in improving postoperative pelvic visceral dysfunctions of benign uterine disease patients.
  
  
  METHODS
  From January 2008 to January 2010, a total of 300 patients diagnosed with benign uterine diseases at the Second Affiliated Hospital of Nantong University were enrolled. Of those, 150 randomly selected patients underwent modified panhysterectomy (research group), while the other 150 patients underwent conventional panhysterectomy (control group). The surgery-related parameters, including operation time, intraoperative blood loss, length of hospital stay, postoperative indwelling catheter time, and first voiding and defecation time were compared between the two groups. The extent of nerve damage in both groups was examined using the nerve-specific marker S-100 via immunohistochemistry. Besides, postoperative assessments of bladder and bowel functions were conducted within 1 year after the operation.
  
  
  RESULTS
  The surgery-related parameters in the two groups showed no significant difference (p > 0.05). Immunohistochemistry results showed significantly reduced damage of the nerves in the research group. We also found a better bladder and bowel function in the research group (p < 0.05) and in younger patients (p < 0.05) compared with that in the control group. Recovery trends of the bladder and bowel function were found in both groups (χ(2) = 7.512, p = 0.006 in the research group; χ(2) = 7.299, p = 0.007 in the control group).
  
  
  CONCLUSIONS
  Modified panhysterectomy for benign uterine diseases seems feasible and safe, with the main advantage of improving postoperative urocystic and rectal dysfunctions through the preservation of the pelvic autonomic nerves.
authors.affiliation: Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Nantong University, Nantong, PR China.
authors.forename: Liping
authors.initials: L
authors.lastname: Chen
authors.forename: Manhua
authors.initials: M
authors.lastname: Liu
authors.forename: Xiaoqin
authors.initials: X
authors.lastname: Huang
authors.forename: Yanli
authors.initials: Y
authors.lastname: Zheng
authors.forename: Junjun
authors.initials: J
authors.lastname: Qiu
authors.forename: Hongbin
authors.initials: H
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D003248:Constipation / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007150:Immunohistochemistry; D007902:Length of Stay; D008593:Menopause; D008875:Middle Aged; D061646:Operative Time; D059348:Peripheral Nerve Injuries / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control; D009418:S100 Proteins / Q000032:analysis; D013997:Time Factors; D014555:Urination Disorders / Q000453:epidemiology / Q000209:etiology; D014591:Uterine Diseases / Q000601:surgery*; D014599:Uterus / Q000737:chemistry / Q000294:innervation*
chemical_list: D009418:S100 Proteins