The Investigation Of Bladder Function After The Systematic Nerve-sparing Radical Hysterectomy

Background: At the beginning of twenty century, Wertheim put the theory of extensive abdominal radical hysterectomy and pelvic lymph node dissection, which laid the foundation for the radical surgery of cervical cancer and had become the classic operative methods of this disease. While , the main injury of autonomic nerve during operation because of big trauma and wide operative scope brought patients many complications, such as bladder dysfunction, rectum dysfunction, decrease and loss of sexual function. In order to reduce the complications and promote the quality of life, how to avoid and reduce the injury to bladder, rectum and sexual nerve is the key of the surgery. So, we compare the clinical effect, the operation time , the blood loss and the PVR of the nerve preservation group with the control group to investigate the probability of the systematic never-sparing radical hysterectomy.Methods: From August 2008 to Mar 2009, 96 patients who did the surgery divided into two groups: 43 patients with systematic never-sparing radical hysterectomy (the nerve preservation group) and 53 patients without nerve preservation technique (the control group ). Compare the clinical effect, the operation time , the blood loss and the PVR of the nerve preservation group with the control group.Results: The average operation time of the non-nerve-sparing patients was 197.4±32.5min and the nerve-sparing with the same operator was 226.0±31.6min. The average blood loss of the non-nerve-sparing patients was 313.0±146.7ml and the nerve-sparing with the same operator was 348.1±164.1ml. On the six to fourteen days after never-sparing surgery, 30 patients (69.73%) whose PVR were less than 100ml were voiding spontaneously, while 13 patients (30.23%) whose PVR were more than 100ml were discharged with self-catheterization. On the twenty one to twenty four days after never-sparing surgery, 40 patients (93.02%) whose PVR were less than 100ml were voiding spontaneously, while 3 patients (6.98%) whose PVR were more than 100ml were discharged with self-catheterization. On the twenty one to twenty four days after non-never-sparing surgery, 41 patients (77.36%) whose PVR were less than 100ml were voiding spontaneously, while 12 patients (22.63%) whose PVR were more than 100ml were discharged with self-catheterization. Two groups had significant difference on the post-void residual urine volume (PVR).Conclusions: The operation time of the nerve-sparing patients is more than the non-nerve sparing patients and the blood loss of the nerve-sparing patients is also more than the non-nerve sparing patients. But the effect of bladder function with systematic never- sparing radical hysterectomy is better than radical hysterectomy. The incidence of postoperative urinary dysfunction seems lowered . And the nerve-sparing technique could be useful method for reducing the complications and promoting the quality of life.