Beyond bladder dysfunction: assessing the full impact of radical hysterectomy on cervical cancer patients

Abstract

Although bladder dysfunction is the most commonly reported complication after radical hysterectomy, there are other significant complications associated with cervical cancer surgery that have received less attention in the literature. This study aims to investigate the frequency of non-functional complications related to radical hysterectomy and identify significantly related risk factors associated with their occurrence.A retrospective study was conducted on consecutive patients diagnosed with early-stage cervical cancer who underwent radical hysterectomy at La Paz University Hospital between 2005 and 2019. The study collected data on intraoperative, short-term and long-term complications, and a multivariate analysis was performed to identify potential predictors of surgical complications. Of the 111 patients included in the study, 11.7% experienced intraoperative complications. Multivariate analysis indicated that the presence of microscopic parametrial involvement was significantly associated with an increased risk of intraoperative complications (Odds ratio (OR) = 16.7; 95% Confindent interval (CI): 1.4-195). Urological complications were the most common short-term complications, affecting 14.4% of the patients. On the other hand, lymphedema was the most frequent long-term complication, with a prevalence of 18%. In univariate analysis, the International Federation of Gynecology and Obstetrics (FIGO) stage tended to be associated (p = 0.05) with postoperative complications. Furthermore, the performance of selective sentinel lymph node biopsy instead of lymphadenectomy was associated with a reduced incidence of lymphedema, from 18% to 3.8%. While urological complications are the most common after radical hysterectomy, other complications, such as genitourinary fistula or lymphedema, while less frequent, are also significant due to their negative impact on patients' quality of life. Thus, an accurate preoperative diagnosis is essential to prevent surgical complications.