Bladder Function Following Nerve-sparing Radical Hysterectomy: a Retrospective Cohort Study in Hong Kong

Abstract

Objective: To compare radical hysterectomy with nerve-sparing radical hysterectomy in terms of bladder function and perioperative complications.
Methods: The records of 56 patients having radical hysterectomy (n=30) and nerve-sparing radical hysterectomy (n=26) were reviewed. Postoperative bladder function assessment consisted of the time to: (a) achieve voiding with a residual urine volume of <100 ml, (b) feel bladder fullness after voiding, and (c) obtain satisfaction after micturition.

Results: Those having nerve-sparing radical hysterectomy had a significantly shorter time to bladder function recovery in terms of voiding residual volume of <100 ml (median, 3; range, 1-51 days) than non–nerve-sparing group (median, 7; range, 2-138 days) [p=0.003]. There was significant difference between nerve-sparing radical hysterectomy and radical hysterectomy groups regarding the numbers of patients self-catheterizing (4 vs 12; p=0.042) and self-satisfactory micturition (median [range] days: 4 [1-51] vs 8 [3-138]; p=0.001). The groups did not differ significantly in terms of bladder sensation, operating time and other complications, but the nerve-sparing group had a less median blood loss (500 vs 800 ml; p=0.011).
Conclusion: The nerve-sparing radical hysterectomy appeared superior to non–nerve-sparing radical hysterectomy in terms of bladder dysfunction, without increasing in operating time and complication, whilst their hospital stays were shorter.