Effect of simple and radical hysterectomy on quality of life – analysis of all aspects of pelvic floor dysfunction

Selçuk, Selçuk; Çam, Çetin; Asoğlu, Mehmet Reşit; Küçükbaş, Mehmet; Arınkan, Arzu; Çıkman, Muzaffer Seyhan; Karateke, Ateş

doi:10.1016/j.ejogrb.2016.01.008

Cited by 31 publications

(27 citation statements)

References 28 publications

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“…When evaluating PFD, the different treatment approaches (sole or combined treatments) may be confounding factors of pelvic disorder sequelae 12,13 . Also, cancer itself may be an independent confounding factor in evaluating PFD in survivors, because these symptoms are often more tolerated, if not totally neglected, by many cancer survivors 14,15 .…”

Section: Introductionmentioning

confidence: 99%

Impact of gynecologic cancer on pelvic floor disorder symptoms and quality of life: an observational study

Neron

Bastide

Tayrac

et al. 2019

Sci Rep

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The objective of our observational prospective study was to investigate the severity and prevalence of urinary and pelvic floor disorders in gynecologic cancer survivors. All patients surviving gynecological cancer in the region as well as women receiving invitations to attend breast-screening checkups as the control population were asked to fill-in questionnaires assessing pelvic prolapse symptoms (PFDI-20, Wexner) and associated quality of life (PFIQ-7). Eighty-nine women were included in the cancer survivor group and 1088 in the control group. Pelvic floor symptoms (PFDI-20 questionnaire) were significantly worse in cancer survivors than in control women (score: 33.3 [14.6–74.1] vs. 20 [4.2–50.0], p = 0.0003). Urge incontinence was significantly worse in cancer survivors in both univariable (ORb = 2.061 [95% CI = 1.284–3.309], p = 0.0027) and multivariable analyses (ORa = 1.672 [95% CI = 1.014–2.758], p = 0.0442), as was fecal incontinence in univariable (ORb = 3.836 [95% CI = 1.710–8.602], p = 0.0011) and in multivariable (ORa = 3.862 [95% CI = 1.657–9.001], p = 0.0018) analyses. Women with benign hysterectomies had poorer quality of life and increased pelvic floor disorders compared to women with no history of surgery. Survivors of gynecological cancer experience significantly more pelvic floor symptoms and an associated reduction in quality of life.

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Section: Introductionmentioning

confidence: 99%

Impact of gynecologic cancer on pelvic floor disorder symptoms and quality of life: an observational study

Neron

Bastide

Tayrac

et al. 2019

Sci Rep

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“…Removal of the uterus disrupts the equilibrium between the interactions of the pelvic organs regarding organ descent [20]. Additionally, hysterectomy cures the main "prolapse symptom", but it is less efficient in treating the cause, which is weakened support from musculofascial structures [21]. The void created by hysterectomy can cause a weakened area through which vaginal segments may prolapse [22].…”

Section: Discussionmentioning

confidence: 99%

Long-term experience with a novel uterine-sparing transvaginal mesh procedure for uterovaginal prolapse

Nicita

Villari

Marzi

et al. 2018

European Journal of Obstetrics & Gynecology and Reproductiv

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To evaluate outcomes and quality of life in patients operated transvaginally with an original mesh shape for uterus-sparing prolapse surgery and to demonstrate the safety and efficacy of the technique. Study design: We prospectively evaluated 66 postmenopausal patients (POP-Q Stage III: 32, IV: 34) operated between May 2008 and December 2013. We used wide weave polypropylene monofilament mesh that functions as a hammock anchored posteriorly to sacrospinous ligaments, its anterior wings exit the pelvis through the obturatory membrane. Follow-up was scheduled at 3-, 12-months and in May 2016. Prolapse-Quality of Life Questionnaire (P-QoL) was administered preoperatively, at 12 months and in May 2016. The chi square and Wilcoxon test were used for statistical analysis. Results: Mean follow-up was 5.6 (SD: 1.6, Range: 1.1-8.1) years. The overall success rate (POP-Q 2) was 92.5% at 12 months and 84.4% at May 2016, these data remained stable over time (p > 0.05). Early complications occurred in 2 (3%) patients, late in 5 (7.8%) of which mesh extrusion in 4 (6.3%). Data from P-QoL showed significant improvement between preoperative and postoperative data (P < 0.01 for all domains) and they remained stable with time (p > 0.05). De-novo dyspareunia was 17.6% at 12 months and 10.3% at May 2016. Conclusions: The low rate and grade of complications demonstrates the safety of the procedure, which offers stable anatomical correction with significant improvement in QoL.

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“…Therefore, radical hysterectomy presents a high surgical morbidity due to extensive ureteral and nerve dissection [ 7 ]. They may be responsible for post-operative complications, such as bladder or bowel dysfunction, urinary tract fistula and urinary tract injury [ 8 , 9 ]. However, the resection of the parametrium is of primary importance in early stage cervical cancer, since it may be the main site of disease recurrences [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Nomogram Predicting the Likelihood of Parametrial Involvement in Early-Stage Cervical Cancer: Avoiding Unjustified Radical Hysterectomies

Benoit¹,

Balaya

Guani

et al. 2020

JCM

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Background: We aimed to establish a tool predicting parametrial involvement (PI) in patients with early-stage cervical cancer and select a sub-group of patients who would most benefit from a less radical surgery. Methods: We retrospectively reviewed patients from two prospective multicentric databases—SENTICOL I and II—from 2005 to 2012. Patients with early-stage cervical cancer (FIGO 2018 IA with lympho-vascular involvement to IIA1), undergoing radical surgery (hysterectomy or trachelectomy) with bilateral sentinel lymph node (SLN) mapping with no metastatic node or PI on pre-operative imaging, were included. Results: In total, 5.2% patients (11/211) presented a histologic PI. After univariate analysis, SLN status, lympho-vascular space invasion, deep stromal invasion and tumor size were significantly associated with PI and were included in our nomogram. Our predictive model had an AUC of 0.92 (IC95% = 0.86–0.98) and presented a good calibration. A low risk group, defined according to the optimal sensitivity and specificity, presented a predicted probability of PI of 2%. Conclusion: Patients could benefit from a two-step approach. Final surgery (i.e. radical surgery and/or lymphadenectomy) would depend on the SLN status and the probability PI calculated after an initial conization with bilateral SLN mapping.

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Effect of simple and radical hysterectomy on quality of life – analysis of all aspects of pelvic floor dysfunction

Cited by 31 publications

References 28 publications

Impact of gynecologic cancer on pelvic floor disorder symptoms and quality of life: an observational study

Impact of gynecologic cancer on pelvic floor disorder symptoms and quality of life: an observational study

Long-term experience with a novel uterine-sparing transvaginal mesh procedure for uterovaginal prolapse

Nomogram Predicting the Likelihood of Parametrial Involvement in Early-Stage Cervical Cancer: Avoiding Unjustified Radical Hysterectomies

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