Various types of total laparoscopic nerve-sparing radical hysterectomies and their effects on bladder function.
10.3802/jgo.2014.25.3.198
- Author:
Hiroyuki KANAO
1
;
Kazuko FUJIWARA
;
Keiko EBISAWA
;
Tomonori HADA
;
Yoshiaki OTA
;
Masaaki ANDOU
Author Information
1. Department of Obstetrics and Gynecology, Kurashiki Medical Center, Kurashiki, Japan. b9g05tn0@ms11.megaegg.ne.jp
- Publication Type:Original Article
- Keywords:
Bladder function;
Cervical cancer;
Laparoscopic nerve-sparing radical hysterectomy;
Pelvic nerve network;
Urodynamic study
- MeSH:
Adult;
Aged;
Female;
Humans;
Hypogastric Plexus/injuries;
Hysterectomy/adverse effects/*methods;
Laparoscopy/adverse effects/*methods;
Middle Aged;
Neoplasm Staging;
Pelvis/innervation;
Peripheral Nerve Injuries/etiology/*prevention & control;
Postoperative Period;
Urinary Bladder/*innervation/physiopathology;
Urodynamics;
Uterine Cervical Neoplasms/pathology/*surgery
- From:Journal of Gynecologic Oncology
2014;25(3):198-205
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: This study was conducted to ascertain the correlation between preserved pelvic nerve networks and bladder function after laparoscopic nerve-sparing radical hysterectomy. METHODS: Between 2009 and 2011, 53 patients underwent total laparoscopic radical hysterectomies. They were categorized into groups A, B, and C based on the status of preserved pelvic nerve networks: complete preservation of the pelvic nerve plexus (group A, 27 cases); partial preservation (group B, 13 cases); and complete sacrifice (group C, 13 cases). To evaluate bladder function, urodynamic studies were conducted preoperatively and postoperatively at 1, 3, 6, and 12 months after surgery. RESULTS: No significant difference in sensory function was found between groups A and B. However, the sensory function of group C was significantly lower than that of the other groups. Group A had significantly better motor function than groups B and C. No significant difference in motor function was found between groups B and C. Results showed that the sensory nerve is distributed predominantly at the dorsal half of the pelvic nerve networks, but the motor nerve is predominantly distributed at the ventral half. CONCLUSION: Various types of total laparoscopic nerve-sparing radical hysterectomies can be tailored to patients with cervical carcinomas.
