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Long-term Pelvic Floor Function and Quality of Life After Radical Surgery for Cervical Cancer: A Multicenter Comparison Between Different Techniques for Radical Hysterectomy With Pelvic Lymphadenectomy
  1. Marloes Derks, MD,
  2. Jacobus van der Velden, MD, PhD,
  3. Minke M. Frijstein, MD,
  4. Willemijn M. Vermeer, PhD,
  5. Anne M. Stiggelbout, PhD,
  6. Jan Paul W.R. Roovers, MD, PhD,
  7. Cornelis D. de Kroon, MD, PhD,
  8. Moniek M. ter Kuile, PhD and
  9. Gemma G. Kenter, MD, PhD
  1. * Department of Gynaecologic Oncology, Academic Medical Center-Centre for Gynaecological Oncology, Amsterdam; Departments of
  2. Clinical Psychology,
  3. Medical Decision Making, and
  4. § Gynaecologic Oncology, Leiden University Medical Center, Leiden, the Netherlands.
  1. Address correspondence and reprint requests to Marloes Derks, MD, Department of Gynaecologic Oncology, Academic Medical Center, PO Box 22660, 1100 DD Amsterdam, the Netherlands. E-mail: m.deks{at}


Objective This study aimed to compare urinary and bowel symptoms and quality of life (QoL) among women treated with a Wertheim–Meigs (WM, type III) or Wertheim–Okabayashi (WO, type IV) radical hysterectomy with pelvic lymphadenectomy for early-stage cervical cancer.

Methods In this cross-sectional observational study, patients treated with a WO or a (nerve sparing) WM radical hysterectomy (with or without adjuvant radiotherapy) between January 2000 and December 2010 in the Center for Gynaecological Oncology Amsterdam or Leiden University Medical Center were included. To assess QoL, urinary and bowel symptoms we used the EORTC QLQ-C30, EORTC QLQ-CX24, and Leiden Questionnaire. We performed a multivariate analysis to identify factors associated with urinary symptoms.

Results Two hundred sixty-eight women were included (152 WO and 116 WM). Quality of life was not significantly different in patients treated by WO or WM. Urinary symptoms were more often reported by patients in the WO group compared to the WM group: “feeling of urine retention” (53% vs 32%), “feeling less/no urge to void” (59% vs 14%), and “timed voiding” (49% vs 10%). With regard to bowel symptoms, there was no difference between both. Multivariate analysis showed that surgical technique was an independent factor for differences in urinary symptoms.

Conclusions Patients undergoing more radical surgery for early-stage cervical cancer report significantly more urinary dysfunction, whereas bowel function and health-related QoL are not decreased.

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  • The authors declare no conflicts of interest.