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Quality of Life and Sexual, Bladder, and Intestinal Dysfunctions After Class III Nerve-Sparing and Class II Radical Hysterectomies

2009; BMJ; Volume: 19; Issue: 5 Linguagem: Inglês

10.1111/igc.0b013e3181a2d171

1525-1438

Antonino Ditto, Fabio Martinelli, Claudia Borreani, Shigeki Kusamura, Francesco Hanozet, Cinzia Brunelli, Gabriela Rossi, Eugenio Solima, Rosanna Fontanelli, Flavia Zanaboni, Barbara Grijuela, Francesco Raspagliesi,

Uterine Myomas and Treatments

Background: To compare quality of life and bladder, intestinal, and sexual dysfunctions in 2 groups of patients undergoing different types of radical hysterectomies (RHs). Methods: Patients with cervical cancer who underwent RH have been enrolled in a questionnaire-based study. Quality of life (QoL) and bladder, intestinal, and sexual dysfunctions were evaluated with the Functional Assessment of Cancer Therapy-Cervix (FACT-Cx). Patients were grouped according to the type of RH: group 1, class II RH and group 2, class III nerve-sparing RH (NSRH). Results: Of 157 women included in the study, 127 filled out the questionnaire. Overall, QoL score assessed with the FACT questionnaire did not differ significantly between the 2 groups. The FACT subscales assessing physical, functional, emotional, and social well-being did not differ significantly between the 2 groups, whereas the FACT-Cx subscales assessing disease-related symptoms in group 2 patients showed a significantly worse score (72 vs 66; P = 0.03). Evaluating singularly the 15 items of the Cx subscales assessing disease-related symptoms, we did not find any significant difference between the 2 groups, but only Cx1 ("I am bothered by discharge or bleeding from my vagina") was significantly worse in group 2 patients. At univariate analysis, we found that NSRH and adjuvant radiotherapy (RT) impact negatively on the FACT-Cx subscales regarding pelvic visceral function. However, at multivariate analysis, only adjuvant RT impact negatively. Conclusions: Patients submitted to class III NSRH did not present worse QoL and pelvic visceral dysfunctions when compared with class II RH. The RT seems to be a factor impacting negatively on bladder and sexual function.