Quality of life and sexual, bladder, and intestinal dysfunctions after class III nerve-sparing and class II radical hysterectomies: a questionnaire-based study

Int J Gynecol Cancer. 2009 Jul;19(5):953-7. doi: 10.1111/IGC.0b013e3181a2d171.

Abstract

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.

Publication types

  • Comparative Study

MeSH terms

  • Cross-Sectional Studies
  • Female
  • Humans
  • Hysterectomy / methods*
  • Intestinal Diseases / diagnosis
  • Intestinal Diseases / etiology*
  • Middle Aged
  • Postoperative Complications*
  • Quality of Life*
  • Sexual Dysfunction, Physiological / diagnosis
  • Sexual Dysfunction, Physiological / etiology*
  • Surveys and Questionnaires
  • Urinary Bladder Diseases / diagnosis
  • Urinary Bladder Diseases / etiology*
  • Uterine Cervical Neoplasms / radiotherapy
  • Uterine Cervical Neoplasms / surgery*