Our Summary

This study compares two types of surgery for removing the uterus due to cancer: laparoscopic nerve-sparing radical hysterectomy (LNSRH) and classical laparoscopic radical hysterectomy (LRH). The goal was to see which surgery was better at preserving bladder function.

298 patients who had one of these surgeries were studied. They found that patients who had the nerve-sparing surgery (LNSRH) had a shorter time with a post-surgery catheter, which is a tube to help with urination. They also had fewer issues with bladder control, longer time to urinate, pain during urination, and continuous urine flow.

In the group that had the nerve-sparing surgery, bladder function returned to normal more quickly. For example, they found that by 6 months after surgery, the frequency of needing to urinate in the middle of the night returned to pre-surgery levels.

The researchers concluded that the nerve-sparing surgery (LNSRH) is better at preserving bladder function, but they also noted the importance of being cautious about potential damage to the surrounding nerves during the surgery.

FAQs

  1. What is the difference between laparoscopic nerve-sparing radical hysterectomy (LNSRH) and classical laparoscopic radical hysterectomy (LRH)?
  2. How does laparoscopic nerve-sparing radical hysterectomy (LNSRH) affect bladder function compared to classical laparoscopic radical hysterectomy (LRH)?
  3. What are the potential risks or drawbacks of laparoscopic nerve-sparing radical hysterectomy (LNSRH)?

Doctor’s Tip

A helpful tip a doctor might tell a patient about radical hysterectomy is to ask about the possibility of having a nerve-sparing surgery (LNSRH) to help preserve bladder function. This type of surgery may result in a shorter time with a catheter post-surgery, fewer issues with bladder control, and a quicker return to normal bladder function. It is important to discuss the potential benefits and risks of this type of surgery with your doctor.

Suitable For

Patients who are typically recommended for radical hysterectomy are those with early-stage cervical cancer, endometrial cancer, or other gynecological cancers that have not spread beyond the uterus. The decision to undergo a radical hysterectomy is usually made by a multidisciplinary team of healthcare providers, including gynecologic oncologists, surgeons, and radiation oncologists.

In particular, patients who may benefit from nerve-sparing radical hysterectomy (LNSRH) are those who are concerned about preserving bladder function and avoiding potential side effects such as urinary incontinence or difficulty with urination. It is important for patients to discuss their individual concerns and treatment goals with their healthcare provider to determine the most appropriate surgical approach for their specific case.

Timeline

Before radical hysterectomy:

  • Patient is diagnosed with cancer of the uterus or cervix
  • Patient undergoes pre-operative tests and consultations with healthcare providers
  • Patient discusses treatment options with their healthcare team
  • Patient decides to undergo radical hysterectomy as treatment for their cancer

After radical hysterectomy:

  • Patient undergoes surgery to remove the uterus, cervix, and surrounding tissues
  • Patient may experience pain, discomfort, and fatigue post-surgery
  • Patient is monitored in the hospital for a few days after surgery
  • Patient may have a catheter inserted to help with urination
  • Patient may experience changes in bladder function, such as frequency of urination and pain during urination
  • Patient may need to follow up with their healthcare team for monitoring and follow-up care
  • Patient may need to undergo rehabilitation or physical therapy to regain strength and function after surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about radical hysterectomy include:

  1. What are the potential risks and complications associated with a radical hysterectomy?
  2. How will my bladder function be affected by the surgery?
  3. What is the difference between laparoscopic nerve-sparing radical hysterectomy (LNSRH) and classical laparoscopic radical hysterectomy (LRH)?
  4. What are the benefits of having a nerve-sparing surgery in terms of bladder function?
  5. Will I need a catheter after the surgery, and if so, for how long?
  6. How long does it typically take for bladder function to return to normal after the surgery?
  7. What measures will be taken during the surgery to preserve bladder function?
  8. Are there any specific exercises or treatments that can help improve bladder function after the surgery?
  9. What is the success rate of nerve-sparing surgery in terms of preserving bladder function?
  10. What should I expect in terms of recovery and follow-up care after the surgery?

Reference

Authors: Liu Q, Li P, Sun Y, Zhang S, Liu K. Journal: J Invest Surg. 2020 Apr;33(4):381-386. doi: 10.1080/08941939.2018.1502377. Epub 2018 Oct 31. PMID: 30380342