Nerve-sparing in Gynecologic Surgery: A Perspective

Abstract

To provide a perspective on nerve-sparing (NS) surgery in gynecology. Data Sources: Literature review, English language. Methods of Study Selection: Systematic reviews and meta-analyses studies were selected for review for oncology; comparative studies were selected for endometriosis, and 1 comparative and 1 prospective study were chosen for sacrocolpopexy. Tabulation, Integration, and Results: Two tables summarize the results of systematic reviews and meta-analyses in oncology. Oncology, endometriosis, and urogynecology sections. Primary benefit of NS technique is decreased bladder dysfunction, and, to a lesser degree, vaginal and rectal dysfunc. Conclusion: NS is preferable to conventional surgery for benign and malignant conditions to reduce postoperative bladder, rectal, and vaginal dysfunction.

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“…Whenever necessary, the surgery included adhesiolysis, ovarian surgery, removal of the involved peritoneal tissues, dissection of parametrial planes, isolation of ureteral course (ureterolysis), lateral parametrectomy, posterior parametrectomy, deep uterine vessels identification, colpectomy, bowel resection, etc. The fundamental proposal of nervesparing surgery has been the least possible damage to the pelvic innervation in order to reduce postoperative bladder, rectal, and vaginal dysfunction [25].…”