Department of Gynecologic Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
J Obstet Gynaecol. 2022 Apr;42(3):514-517. doi: 10.1080/01443615.2021.1920004. Epub 2021 Jun 25.
Radical hysterectomy (RH) may cause lower urinary tract symptoms (LUTS) for patients with cervical cancer. Few data are available on the long-term LUTS of these patients and whether the symptoms relate to the route of surgery remain unclear. Here, we assessed the long-term urinary dysfunction in cervical cancer patients after RH based on a self-reported questionnaire. A total of 168 patients after type C2 RH, either by laparoscopy (LRH) or laparotomy (ARH), were analysed. The median length of follow-up was 54 ± 8.35 months. The total incidence of urinary dysfunction was around 40%. Patients with LRH had more intermittent stream and feeling of incomplete emptying than those in ARH group. Our data indicate the irreversible damage of RH to urinary function of cervical cancer patients, who should be informed of the long-term and high incidence of urinary dysfunction after RH when they choose surgical treatment.Impact Statement Radical hysterectomy (RH) with pelvic lymphadenectomy is standard surgical care for patients with cervical cancer. RH could induce urinary dysfunction, including bladder sensation loss, hypertonic and hypotonic bladder, urinary incontinence, etc. Studies mainly focus on short- or mid-term urinary dysfunction and stated that spontaneous recovery of urinary function is to be expected within 6-12 months after surgery. The lower urinary tract symptoms last for years after type C2 RH, indicating the irreversible damage of RH to urinary function of cervical cancer patients. The incidence of bladder dysfunction is increased in patients submitted to laparoscopic RH compared to abdominal RH. Cervical cancer patients should be informed of the long-term and high incidence of urinary dysfunction after RH when they choose surgical treatment.
根治性子宫切除术 (RH) 可能会导致宫颈癌患者出现下尿路症状 (LUTS)。关于这些患者的长期 LUTS 数据很少，并且症状是否与手术途径有关尚不清楚。在这里，我们根据自我报告的问卷评估了 RH 后宫颈癌患者的长期尿功能障碍。共分析了 168 例接受 C2 型 RH 的患者，其中 83.5 个月接受腹腔镜（LRH）或剖腹手术（ARH）。中位随访时间为 54±8.35 个月。尿功能障碍的总发生率约为 40%。LRH 组患者间歇性排尿和排空不完全感的发生率高于 ARH 组。我们的数据表明，RH 对宫颈癌患者的尿功能具有不可逆转的损害，当患者选择手术治疗时，应告知其 RH 后长期且高发生率的尿功能障碍。
影响陈述 RH 联合盆腔淋巴结清扫术是宫颈癌患者的标准手术治疗方法。RH 可引起尿功能障碍，包括膀胱感觉丧失、高张力和低张力膀胱、尿失禁等。研究主要集中在短期或中期尿功能障碍上，并指出术后 6-12 个月内有望恢复尿功能。C2 型 RH 后下尿路症状持续数年，表明 RH 对宫颈癌患者的尿功能具有不可逆转的损害。与剖腹 RH 相比，腹腔镜 RH 患者的膀胱功能障碍发生率增加。当患者选择手术治疗时，应告知其 RH 后长期且高发生率的尿功能障碍。
