Introduction/Background Despite the use of nerve-sparing technique, bladder dysfunction remains the leading morbidity associated with parametrectomy (radical hysterectomy or trachelectomy). Our aim was to analyze the time to postoperative voiding recovery and the factors influencing it in the SENTIX trial cohort, in whom different types of surgical approach and parametrectomy was used.
Methodology The SENTIX trial is a prospective cohort international study on sentinel lymph node biopsy without pelvic lymphadenectomy in patients with early-stage cervical cancer (≤4 cm or ≤2cm in fertility sparing). It entails 46 sites from 18 countries. Ad hoc analysis of data from the SENTIX trial was performed to assess factors influencing voiding recovery, which was defined as the number of days from surgery to bladder catheter or epicystostomy removal with post-voiding urine residuum <50 mL.
Result The characteristics of the cohort of 372 patients are shown in table 1. Median (range) voiding recovery time was 3 (0–21) days; it was <7 days in 288 (78.5%) patients and <1 month in 357 (97.3%). Among 10 (2.7%) patients with recovery >1 month, only 1 case (80 days) was not associated with any severe intraoperative complication (6 cases) or adjuvant radiotherapy (3 cases). Tumor size >2 cm, open surgery, and a more extensive type of parametrectomy significantly influenced voiding recovery (figure 1). In multivariate analysis, only previous pregnancy and type of parametrectomy were significant (table 2).
Conclusion Voiding recovery time is directly related to the extent of parametrectomy. It is, however, temporary and almost all patients recover within 1 month, even after a more radical procedure (C2). The higher risk associated with laparotomy reflects a tendency to be more radical with open surgery.
Disclosure This work was supported by a grant from the Czech Research Council (No 16-31643A). There are no conflicts of interest.
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