Bowel Dysfunction following Nerve-Sparing Radical Hysterectomy for Cervical Cancer: A Prospective Study

Loizzi, Vera; Cormio, Gennaro; Lobascio, Pierluigi; Marino, F.; Fazio, Michele De; Falagario, M; Leone, Luca; Difiore, G.; Scardigno, D.; Selvaggi, Luigi; Altomare, D. F.

doi:10.1159/000362213

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…observed in their study that resting and squeeze sphincter pressures, volume of saline infused at first leak, total volume retained, and threshold volume for maximum tolerable volume are all decreased significantly after hysterectomy for cervical cancer14. However, in more recent work of Loizzi et.al., it was found that maximal and mean anal resting and squeezing pressures were unaffected by the surgical procedure, rectoanal inhibitory reflex and length of the high anal pressure zone did not change when a nerve sparing technique was used15. In our study, there was no statistically significant difference between the groups both in abdominal hysterectomy group and in vaginal hysterectomy group in terms of the manometry results before and after the operation.…”

Section: Discussioncontrasting

confidence: 49%

Effects of abdominal and vaginal hysterectomy on anorectal functions along with quality of life of the patient

Birsen

Ozban

et al. 2018

Afr H. Sci.

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Objectives and backgroundHysterectomy is the most commonly performed major gynecological operation for both benign and malign gynecologic conditions. After hysterectomy, although some investigators have declared an increased incidence of urinary and anorectal dysfunction, some others could not show any connection.MethodsThe voluntary patients were divided in two groups: abdominal hysterectomy (Group 1) and vaginal hysterectomy (Group 2). Anal manometry and all the other examinations of the patients were performed at the Department of General Surgery Endoscopy Unit of Ankara University, Faculty of Medicine.ResultsWhen the quality of life of the patients was assessed before the operation and on the 12th post-operative month via the SF-36 form; it can be seen that body pain parameters of the patients in Group 1 had significantly improved and there is no statistical difference in other parameters. When the effect of hysterectomy on the quality of life of the patients was evaluated by the “Cleveland Clinic Global Quality of Life” form, the statistically significant improvement in the quality of life of the patients in Group 2 was observed.ConclusionIf the type of operation (vaginal or abdominal) is performed due to benign causes, it does not affect the urinary and anorectal functions of the patients. Depending on the decrease of complaints of the patients, it has a positive effect on the quality of life.

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Section: Discussioncontrasting

confidence: 49%

Effects of abdominal and vaginal hysterectomy on anorectal functions along with quality of life of the patient

Birsen

Ozban

et al. 2018

Afr H. Sci.

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“…Importantly, 55 % of women continued to report functional diffi culties as late as 18 months, including constipation and the onset of fecal incontinence. To opposite manometric fi ndings came Loizzi et al [ 48 ] investigating 21 women 6 months after nerve-sparing RH: no changes from baseline were observed after surgery in any of the tested parameters, including rectal compliance.…”

Section: Anorectal Dysfunctionsmentioning

confidence: 94%

Preserving Sexual Function and Continence during Radical Hysterectomy

Landoni

Zanagnolo

Soligo

2016

Functional Urologic Surgery in Neurogenic and Oncologic Diseases

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IntroductionCervical cancer is, after breast cancer, the second highest worldwide female malignancy. The incidence has been increasing gradually over recent years, with younger patients resulting affected. Thus, it is becoming one of the most deadly cancer globally [ 1 -4 ].The age-adjusted incidence rate rises rapidly in the third decade of life to approximately 20 cases per 100,000 and then increases slowly to 30 through the ninth decade. Although cervical cytology may potentially reduce the mortality rate of cervical cancer by 80 %, this procedure has only been fully implemented in few countries because of its costs and logistical problems resulting from the high incidence of cervical cancer precursors [ 5 ].Various types of radical surgery (RS), such as radical hysterectomy, radical trachelectomy, and radical parametrectomy, have shown 5-year survival rates ranging between 75 and 90 % [ 1 , 5 , 6 ], remaining the standard treatment for patients with early-stage cervical cancer [ 7 -9 ]. However, RS is known to cause urinary dysfunctions, such as bladder hypotonia, urinary incontinence, and abnormal sensation, in 12-85 % of patients [ 10 -12 ]. Furthermore, bowel dysfunctions, such as constipation, have been reported in 5-10 % of patients after RS [ 13 , 14 ].Considerable sexual dysfunctions, including decrease in sexual interest, orgasm, and vaginal dryness, may also be reported after RS. The sexual activity impairment thus results in substantial distress [ 15 ]. Urinary, anorectal, and sexual dysfunctions are known to be caused, during RS, by the disruption of sympathetic and parasympathetic

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“…Due to the morbidity of parametrectomy, some services are developing an autonomic nerve-sparing radical hysterectomy, both minimally invasive and by laparotomy, in order to decrease the nervous sequelae in the vagina, bladder and rectum. A recent study has shown that this technique is associated to lower anorectal dysfunction 26 . Another long-term study showed that laparoscopy for radical hysterectomy improves nervous dissection and preservation due to the better magnification 27 .…”

Section: Laparoscopic Lymphadenectomy Laparoscopic Lymphadenectomy Lamentioning

confidence: 98%

Laparoscopy in uterine cervical cancer. Current state and literature review

Tsunoda

Andrade

Vieira

et al. 2015

Rev. Col. Bras. Cir.

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ABSTRACT ABSTRACT ABSTRACTCervical cancer remains the most frequent gynecological tumor in Brazil and other developing countries. Minimally invasive techniques, especially laparoscopy, have been increasingly employed in such tumors. This article aims to describe the main applications of laparoscopy in the treatment and staging of cervical cancer. In the early stages, it is possible to provide a fertilitypreserving surgery in the form of radical trachelectomy and, in a study protocol, the function-preserving surgery, avoiding parametrectomy and the associated morbidity. A fully laparoscopic radical hysterectomy is fairly standard in the literature and has the tendency to become the standard of care in early cases, for patients who want to bear no more children. In advanced stages, minimally invasive surgery can offer ovarian transposition, with intent to prevent actinic castration, without upsetting the time for the start of radiotherapy and chemotherapy. Staging laparoscopic surgery, including pelvic and para-aortic lymphadenectomy, has been the subject of studies, since it has the potential to modify the extension of radiotherapy depending on the extent of lymph node spread.

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Bowel Dysfunction following Nerve-Sparing Radical Hysterectomy for Cervical Cancer: A Prospective Study

Cited by 5 publications

References 25 publications

Effects of abdominal and vaginal hysterectomy on anorectal functions along with quality of life of the patient

Effects of abdominal and vaginal hysterectomy on anorectal functions along with quality of life of the patient

Preserving Sexual Function and Continence during Radical Hysterectomy

Laparoscopy in uterine cervical cancer. Current state and literature review

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