title: Urinary and anal dysfunction after laparoscopic versus laparotomic radical hysterectomy.
abstract: OBJECTIVE
  The aim of this study was to compare urinary and anal dysfunction after laparoscopic (LRH) and abdominal (ARH) radical hysterectomy for cervical cancer.
  
  
  METHODS
  Consecutive patients who underwent radical hysterectomy for treatment of cervical cancer were enrolled in this study and divided into two groups, according to the surgical approach. Urinary and anal symptoms were evaluated before and 6 months after surgery.
  
  
  RESULTS
  Fifty-four women were considered: 27 LRH and 27 ARH. Urinary incontinence was significantly more frequent both after LRH (37% vs 86.9%, p=0.0004) and after ARH (33.3% vs 100%, p<0.0001); urge incontinence (3.7% vs 29.6%, p=0.02) and increased bladder sensation (0 vs 22.2%, p=0.02) were significantly more common postoperatively in patients undergone ARH. In both groups more patients complain about increase of straining during voiding (LRH: 0 vs 34.7%, p=0.009; ARH: 3.7% vs 29.6% p=0.02) after surgery. Postoperative constipation by obstructed defecation was more frequent after ARH (Wexner score: 0 vs 2, p=0.03) but not after LRH.
  
  
  CONCLUSIONS
  From our results, laparoscopic approach for radical hysterectomy seems to reduce the postoperative occurrence of urge incontinence, increased bladder sensation and constipation by obstructed defecation, in comparison with abdominal radical surgery.
authors: Department of Obstetrics and Gynaecology, Medical University of Vienna, Austria; Department of Obstetrics and Gynaecology, Insubria University, Varese, Italy. Electronic address: rmslaterza@libero.it.
authors: Rosa M
authors: RM
authors: Laterza
authors: Department of Obstetrics and Gynaecology, Vita Salute University School of Medicine San Raffaele Scientific Institute, Milano, Italy; Department of Obstetrics and Gynaecology, Insubria University, Varese, Italy.
authors: Stefano
authors: S
authors: Salvatore
authors: Department of Obstetrics and Gynaecology, Insubria University, Varese, Italy.
authors: Fabio
authors: F
authors: Ghezzi
authors: Department of Obstetrics and Gynaecology, Insubria University, Varese, Italy.
authors: Maurizio
authors: M
authors: Serati
authors: Department of Obstetrics and Gynaecology, Medical University of Vienna, Austria.
authors: Wolfgang
authors: W
authors: Umek
authors: Department of Obstetrics and Gynaecology, Medical University of Vienna, Austria.
authors: Heinz
authors: H
authors: Koelbl
mesh_terms: D000328:Adult; D003248:Constipation / Q000209:etiology*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D010535:Laparoscopy / Q000009:adverse effects*; D007813:Laparotomy / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D014549:Urinary Incontinence / Q000209:etiology*; D002583:Uterine Cervical Neoplasms / Q000601:surgery*
keywords: Abdominal radical hysterectomy; Anal dysfunction; Laparoscopic radical hysterectomy; Urinary dysfunction