Short and long-term urodynamic and quality of life assessment after nerve sparing radical hysterectomy: a prospective pilot study.
OBJECTIVE
The aim of this study was to compare pre- and postoperative bladder function and quality of life (QoL) in women diagnosed with gynecologic malignancy and treated with nerve sparing radical hysterectomy (NSRH).


METHODS
Before and after NSRH for uterine malignancy, bladder function was prospectively assessed in a small cohort of 12 women (39-72 years) suffering from uterine malignancy using urodynamic studies and a validated self-administered condition specific QoL questionnaire. Urodynamic studies were performed one day before (U0) as well as one week (U1) and 22 months (U2) after surgery. The questionnaire was applied at U0 and U2.


RESULTS
Cystometry showed detrusor contractions leading to overactive bladder incontinence in six out of nine women at short-term, which persisted in three women at long-term follow-up leading to a significant impaired QoL. Voiding function and bladder sensation remained uncompromised after surgery.


CONCLUSIONS
NSRH preserves voiding function and bladder sensation. However, short and long-term urodynamic detrusor overactivity and urge incontinence was observed in a significant number of women although symptoms improved over time. These data are important for counselling women and for the design of larger studies to assess the benefits of NSRH versus conventional radical hysterectomy (RH).
Department of Obstetrics and Gynecology, Cantonal Hospital of Lucerne, 6000 Lucerne 16, Switzerland. Electronic address: Juliane.Kruppa@usz.ch.
Juliane
J
Kruppa
Department of Obstetrics and Gynecology, Cantonal Hospital of Lucerne, 6000 Lucerne 16, Switzerland.
Tilemachos
T
Kavvadias
Department of Obstetrics and Gynecology, Cantonal Hospital of Lucerne, 6000 Lucerne 16, Switzerland.
Stefanie
S
Amann
Department of Obstetrics and Gynecology, Cantonal Hospital of Lucerne, 6000 Lucerne 16, Switzerland.
Kaven
K
Baessler
Department of Obstetrics and Gynecology, Cantonal Hospital of Lucerne, 6000 Lucerne 16, Switzerland.
Bernhard
B
Schuessler
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000601:surgery; D016889:Endometrial Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D001743:Urinary Bladder / Q000503:physiopathology*; D053201:Urinary Bladder, Overactive / Q000503:physiopathology*; D014549:Urinary Incontinence / Q000503:physiopathology*; D014563:Urodynamics / Q000502:physiology*; D002583:Uterine Cervical Neoplasms / Q000601:surgery
Detrusor overactivity incontinence; Nerve sparing radical hysterectomy; Quality of life; Urodynamic study; Voiding function