Pelvic floor dysfunction and radical hysterectomy

Int J Gynecol Cancer. 2006 Jan-Feb;16(1):354-63. doi: 10.1111/j.1525-1438.2006.00347.x.

Abstract

Although the survival outcome for treated, early-stage, node-negative cervical cancer is excellent, the operation of radical hysterectomy conveys major morbidity, particularly with respect to bladder and bowel function. There may be some degree of spontaneous recovery, but a significant proportion of postoperative women will have to live with the disabling effects of surgery for decades, and few seek help for their distress. As such, quality of life issues have become highly relevant in the management of this disease, and attention has turned to reducing morbidity, especially to the pelvic viscera. This review presents an overview of the surgical mechanisms presumed to be responsible for pelvic floor denervation and describes subsequent bladder and bowel dysfunction, together with future possibilities for minimizing morbidity, including less radical, more individual surgery, and nerve-sparing techniques.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Hysterectomy / adverse effects*
  • Hysterectomy / methods
  • Incidence
  • Middle Aged
  • Morbidity / trends
  • Pelvic Floor / physiopathology
  • Postoperative Complications / epidemiology*
  • Prognosis
  • Quality of Life*
  • Rectal Diseases / epidemiology*
  • Rectal Diseases / etiology
  • Risk Assessment
  • Urinary Bladder Diseases / epidemiology
  • Urinary Bladder Diseases / etiology
  • Urologic Diseases / epidemiology*
  • Urologic Diseases / etiology
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*