OBJECTIVE: The radical hysterectomy type three can be accompanied
by postoperative morbidity, such as dysfunction of the lower
urinary tract with loss of bladder or rectum sensation. We describe
the technique of laparoscopic nerve-sparing radical hysterectomy
and patient’s outcome.
METHODS: Thirty-two patients underwent laparoscopic nerve-sparing
radical hysterectomy with pelvic lymphadenectomy. Both the
hypogastric and the splanchnic nerves were identified bilaterally
during pelvic lymphadenectomy.
RESULTS: The median age of the patients was 52 years, and the
average operating time was 221 min. There were no intraoperative or
postoperative complications considering the nerve-spring radical
hysterectomy. Postoperatively, in all patients spontaneous voiding
was possible on the third postoperative day with a median residual
urine volume of 50 ml.
CONCLUSIONS: Laparoscopic identification (neurolysis) of the
inferior hypogastric nerve and inferior hypogastric plexus is a
feasible procedure for trained laparoscopic surgeons who have a
good knowledge not only of the retroperitoneal anatomy but also of
the pelvic neuro-anatomy as this qualification could prohibit
long-term bladder and voiding dysfunction during nerve-sparing
Copyright © 2010 Elsevier Inc. All rights reserved.
PMID: 20701958 [PubMed – indexed for MEDLINE]