Nerve sparing radical hysterectomy : feasibility and effect on bladder function

الملخص EN

Objective : to examine the feasibility and effect of autonomic nerve preservation on postoperative bladder function.

Material and Methods : A prospective controlled clinical study of twenty four patients with invasive carcinoma of the cervix, stage I and IIa.

Patients were divided into two groups, 12 patients each.

The first group underwent type III radical hysterectomy without nerve sparing (control group) whiles the other 12 patients underwent the nerve sparing technique.

Patients were compared as regards to the operative time, time needed before the catheter was removed, urodynamic findings, the need for postoperative catheterization for urinary retention and the duration of postoperative stay.

Results were expressed in the form of mean and standard deviation, independent t test was used to compare means with the statistical significance set at p < 0.05.

Results : out of the 12 patients of the study group, the procedure was successful in 10.

The nerve sparing group showed a significant reduction in the postoperative catheterization time.

6 patients in the control group required catheterization for retention following removal of the catheter, compared to 3 patients in the study group.

The closing urethral pressure, maximum bladder capacity and peak flow rate were all significantly higher in the study group.

Conclusion : the nerve sparing technique appears to be a feasible alternative to the classic technique of radical hysterectomy and is associated with better postoperative bladder function.