Effect of Laparoscopic Nerve-Sparing Radical Hysterectomy on Bladder Function Recovery

Background: Radical hysterectomy could result in dysfunctions of pelvic organs and a decline in quality of life. Method: 298 patients who had underwent laparoscopic radical hysterectomy were retrospectively analyzed in this study, of which 216 patients had underwent laparoscopic nerve-sparing radical hysterectomy (LNSRH) and 82 had underwent classical laparoscopic radical hysterectomy (LRH). The mean duration of the postoperative catheterization, a questionnaire and an urodynamic examination were used to assess the bladder functions. Results: The mean duration of the postoperative catheterization in the LNSRH group was shorter than that in the LRH group (13 days versus 18 days, p < 0.01). The incidences of tension urinary incontinence, postoperative voiding time and dysuria symptoms in the LNSRH group, but not in the LRH group, had recovered to preoperative levels in the following 6 months. The frequency of nocturnal urination had recovered to preoperative level at 12 months post-operation in the LNSRH group. The maximum flow rate (MFR), average flow rate (AFR), first voiding sense (FVS), maximum voiding sense (MVS) and maximum detrusor pressure (MDP) in the LNSRH group were better than those in the LRH group (p < 0.05), and patients in the LRH group suffered much more frequently from tension urinary incontinence, prolonged urination time, dysuria and urinary endless compared with those in the LNSRH group (p < 0.05). Conclusion: LNSRH can effectively retain the bladder function, but we should pay attention to the invasion of peripheral nerves.