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Taiwan J Obstet Gynecol · Mar 2012
Controlled Clinical TrialA prospective study of nerve-sparing radical hysterectomy for uterine cervical carcinoma in Taiwan.
- Chih-Jen Tseng, Huang-Pin Shen, Yu-Hsiang Lin, Chung-Yuan Lee, and Will Wei-Cheng Chiu.
- Department of Obstetrics and Gynecology, Chung Shang Medical University Hospital, Taiwan. tsengcj@gmail.com
- Taiwan J Obstet Gynecol. 2012 Mar 1;51(1):55-9.
ObjectiveSurgical therapy for cervical carcinoma carries a significant risk of functional impairment to the bladder. This study evaluates the feasibility and complications of nerve-sparing radical hysterectomy (NRH) in Taiwan.MethodsBetween March 2010 and March 2011, consecutive patients diagnosed with early stage cervical cancer (FIGO stage Ia2 to Ib1) and tumor size < 3 cm were recruited prospectively to undergo NRH or conventional radical hysterectomy (RH). Patients with histories of urinary stress incontinence or bladder dysfunction disease were excluded. A modified Tokyo nerve-sparing radical hysterectomy was performed.ResultsA total of 30 patients were enrolled. Among these, 18 patients underwent NRH with successful bilaterally nerve-sparing procedures in 15 cases (83%), unilaterally nerve-sparing procedures in 2 cases (11%), and a failure in 1 case (6%). The indwelling catheter was removed on postoperative day 6. The mean±SD duration from operation to spontaneous voiding was 6.8 ± 1.5 days for women who underwent NRH; the corresponding duration for women who underwent RH or failed NRH was 20.6 ± 3 days. None of the patients who underwent NRH required intermittent catheterization. All 12 patients who underwent RH needed self-catheterization after discharge. There was a significant reduction in the incidence of postoperative self-catheterization (p<0.01) and bladder dysfunction (p<0.006). Average satisfaction score analyzed by the Likert-scale questionnaire was 4.5 for the NRH group and 1.9 for RH group (p<0.0001).ConclusionsWe concluded that the new technique of NRH can reduce postoperative bladder dysfunctions.Copyright © 2012. Published by Elsevier B.V.
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