Introduction/Background*To determine the incidence of short- and long-term urological complications after surgery in patients with cervical cancer.
Methodology We performed a review involving women who underwent radical hysterectomy or trachelectomy for early-stage cervical cancer during the 2011–2020 period at University Hospital La Fe. Women diagnosed with locally advanced cervical cancer, patients with positive sentinel lymph node (SLN) in the intraoperative study and those with persistent or recurrent disease were excluded.
Result(s)*A total of 96 patients underwent surgery for early-stage cervical cancer. The pre-surgical stage was: IA 8.3%, IB1 74%, IB2 7.3%, IIA1 9.4%, IIB 1%. Radical surgery was performed in 89 patients, fertility preserving surgery in 6 patients and radical colpectomy in 1 patient. Surgery approach was laparotomy, laparoscopy and vaginally in 15.6%, 78.1% and 6.3% of women, respectively. SLN biopsy was performed in 69.8% of patients. The mean operating time was 248.3 minutes and the mean hospital stay was 3.4 days.
The intraoperative and immediate postoperative complication rate (<30 days) was 12.5% and 27% respectively. The Clavien-Dindo classification: II (61.5%), III (38.5%), IV and V (0%). No statistical differences were found according to surgical approach and type of surgery in intraoperative (p=1.00; p=0.47) nor short-term complications (p=1.00; p=0.5). Long-term complication rate (>30days) was 10.4%. No differences were found according to surgical approach and type of surgery (p=0.28; p=0.5). Urological complications occurred in 20 patients (20.8%). Nine of them required ureteral catheter placement, 5 patients required re-intervention and 1 patient a nephrostomy.
Nearly 40% of the patients received adjuvant treatment: 58% only radiotherapy and 42% radiotherapy + chemotherapy. Six patients (6.25%) presented urinary complications after RT and four patients (4.2%) presented long-term urinary complications. No statistical differences in urological complications were found according to RT treatment (p=0.64).
The mean follow-up time was 39.7 months. Eleven patients (11.5%) presented recurrence of their tumour process. Disease-free survival and overall survival at 5 years were 82.1% and 93.4% respectively
Conclusion*Surgery for early cervical cancer leads to urological complications in a considerable percentage of patients, however most of which are mild and self-limiting with medical treatment. Only a small group of patients will experience serious complications in the medium to long term.
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