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Nerve-sparing radical hysterectomy in patients with infiltrative cervical cancer

HEALTH OF WOMAN. 2016.6(112):46–51; doi 10.15574/HW.2016.112.46 

Nerve-sparing radical hysterectomy in patients with infiltrative cervical cancer

Dermenzhy T., Svintitskiy V., Nespryadko S., Legerda L., Stahovsky E., Iatsyna A., Kabanov A.

The National Cancer Institute, Kyiv

Institute of urology of National Academy of medical Sciences of Ukraine, Kyiv

Kiev national University named after T. G. Shevchenko, Kyiv

The objective: to improve an effectiveness of therapy and quality of life of patients with infiltrative cervical cancer using radical hysterectomy accomplished with nerve-sparing methodology.

Patients and Methods: Ninety patients with histologically verified infiltrative cervical cancer were cured with radical hysterectomy (RHE) in the Department of Oncogynecology of National Cancer Institute (Kyiv, Ukraine) in 2012-2016. The age of the patients was from 26 to 65 years (an average age of 42.61±1.06). The patients were distributed in 2 groups: group I treated with nerve-sparing radical hysterectomy (NSRHE), 45 patients, the main group; group II treated with radical hysterectomy (RHE III), the control group, 45 patients. The prognostic indexes in the groups were similar.

Results. NSRHE that included the dissection of cardinal ligament, separation of dorsal and anterior layers of uterovesical ligament allowed separate uterine branch of inferior hypogastric plexus, preserve an innervation of urinary bladder and prevent the malfunction of its contractile function at postoperative period.

Conclusion. The data of the urodynamic study using cystomanometry performed at pre- and early operative periods have shown that surgical treatment of patients with infiltrative cervical cancer with preservation of the major elements of pelvic autonomic plexuses allows significantly decrease the rate of postoperative urogenical malfunctions.

Key words: nerve-sparing radical hysterectomy, cervical cancer, cystomanometry.


1. Kovalev MI, Rohlyna EV. 2011. Diseases cervix: Modern Opportunities of treatment hyrurhycheskoho. Lazernaya medicine 15(3):53–62.

2. Fedorenko ZP, Mihailovych YuY, Gulak LA et al. 2015. Cancer in Ukraine, 2012–2013. Morbidity, mortality, rates of cancer service. Ed. OO Kolesnik. Bulletin of National Cancer Registry of Ukraine 16:101.

3. Dursun P, Ayhan A, Kuscu E. 2009. Nerve-sparing radical hysterectomy for cervical carcinoma. Crit. Rev. Oncol. Hematol. 70(3):195–205. http://dx.doi.org/10.1016/j.critrevonc.2008.09.003; PMid:18926716

4. Kavallaris A, Hornemann A, Chalvatzas N et al. 2010. Laparoscopic nerve-sparing radical hysterectomy: description of the technique and patients’ outcome. Gynecol. Oncol. 119:198–201. http://dx.doi.org/10.1016/j.ygyno.2010.07.020; PMid:20701958

5. Ghezzi F, Cromi A, Uccella S et al. 2013. Nerve-sparing minilaparoscopic versus conventional laparoscopic radical hysterectomy plus systematic pelvic lymphadenectomy in cervical cancer patients. Surg. Innov. 20:493–501. http://dx.doi.org/10.1177/1553350612472986; PMid:23339145

6. Ceccaroni M, Roviglione G, Spagnolo E et al. 2012. Pelvic dysfunctions and quality of life after nerve-sparing radical hysterectomy: a multicenter comparative study. Anticancer Res. 32:581–588. PMid:22287748

7. Chong GO, Lee YH, Hong DG et al. 2013. Robot versus laparoscopic nerve-sparing radical hysterectomy for cervical cancer: a comparison of the intraoperative and perioperative results of a single surgeon’s initial experience. Int. J. Gynecol. Cancer. 23:1145–1149. http://dx.doi.org/10.1097/IGC.0b013e31829a5db0; PMid:23748178