Favorable factors for preserving bladder function after nerve-sparing radical hysterectomy: A protocol-based...

Area of Science:

• Gynecologic Oncology
• Surgical Innovation
• Urogynecology

Background:

• Cervical cancer treatment often involves radical hysterectomy, potentially impacting pelvic autonomic nerves and bladder function.
• Nerve-sparing radical hysterectomy (NSRH) aims to preserve these nerves, but favorable factors and outcomes require further investigation.
• Conventional radical hysterectomy (CRH) serves as a benchmark for safety and efficacy comparisons.

Purpose of the Study:

• To identify factors favoring nerve preservation during NSRH for cervical cancer.
• To assess the impact of nerve preservation on subsequent bladder function.
• To compare the safety and oncological outcomes of NSRH versus CRH.

Main Methods:

• Retrospective analysis of 87 patients undergoing NSRH for IB1-IIA cervical cancer.
• Comparison with 81 historical control patients who underwent CRH.
• Evaluation of factors influencing unilateral or bilateral pelvic autonomic nerve preservation and duration of postoperative catheterization.

Main Results:

• Stage IB1 disease was a significant factor for unilateral/bilateral nerve preservation.
• Stage IB1 disease and squamous cell carcinoma (SqCC) were favorable for bilateral preservation.
• Shorter postoperative catheterization duration was observed in NSRH patients with IB1 disease or SqCC, with no significant difference in survival compared to CRH.

Conclusions:

• Early-stage IB1 cervical cancer and SqCC are favorable indicators for successful nerve preservation in NSRH.
• NSRH can preserve pelvic autonomic nerves and improve bladder function without compromising survival.
• NSRH represents a viable surgical option for select cervical cancer patients, balancing oncological safety with functional preservation.