title: Long-term Pelvic Floor Function and Quality of Life After Radical Surgery for Cervical Cancer: A Multicenter Comparison Between Different Techniques for Radical Hysterectomy With Pelvic Lymphadenectomy.
abstract: This study aimed to compare urinary and bowel symptoms and quality of life (QoL) among women treated with a Wertheim-Meigs (WM, type III) or Wertheim-Okabayashi (WO, type IV) radical hysterectomy with pelvic lymphadenectomy for early-stage cervical cancer.
  
  
  
  In this cross-sectional observational study, patients treated with a WO or a (nerve sparing) WM radical hysterectomy (with or without adjuvant radiotherapy) between January 2000 and December 2010 in the Center for Gynaecological Oncology Amsterdam or Leiden University Medical Center were included. To assess QoL, urinary and bowel symptoms we used the EORTC QLQ-C30, EORTC QLQ-CX24, and Leiden Questionnaire. We performed a multivariate analysis to identify factors associated with urinary symptoms.
  
  
  
  Two hundred sixty-eight women were included (152 WO and 116 WM). Quality of life was not significantly different in patients treated by WO or WM. Urinary symptoms were more often reported by patients in the WO group compared to the WM group: "feeling of urine retention" (53% vs 32%), "feeling less/no urge to void" (59% vs 14%), and "timed voiding" (49% vs 10%). With regard to bowel symptoms, there was no difference between both. Multivariate analysis showed that surgical technique was an independent factor for differences in urinary symptoms.
  
  
  
  Patients undergoing more radical surgery for early-stage cervical cancer report significantly more urinary dysfunction, whereas bowel function and health-related QoL are not decreased.
authors.affiliation: *Department of Gynaecologic Oncology, Academic Medical Center-Centre for Gynaecological Oncology, Amsterdam; Departments of †Clinical Psychology, ‡Medical Decision Making, and §Gynaecologic Oncology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Marloes
authors.initials: M
authors.lastname: Derks
authors.forename: Jacobus
authors.initials: J
authors.lastname: van der Velden
authors.forename: Minke M
authors.initials: MM
authors.lastname: Frijstein
authors.forename: Willemijn M
authors.initials: WM
authors.lastname: Vermeer
authors.forename: Anne M
authors.initials: AM
authors.lastname: Stiggelbout
authors.forename: Jan Paul W R
authors.initials: JP
authors.lastname: Roovers
authors.forename: Cornelis D
authors.initials: CD
authors.lastname: de Kroon
authors.forename: Moniek M
authors.initials: MM
authors.lastname: Ter Kuile
authors.forename: Gemma G
authors.initials: GG
authors.lastname: Kenter
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods; D007422:Intestines / Q000503:physiopathology; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology*; D011788:Quality of Life; D001743:Urinary Bladder / Q000503:physiopathology; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*