Frequency and Management of Urological and Some Other Complications Following Radical Surgery for Carcinoma of the Cervix Uteri, Stages I and II

Abstract

A series of 202 patients with stage I and II carcinoma of the cervix uteri is presented. Radical hysterectomy and pelvic lymph node dissection was performed in all cases and most patients received radiotherapy in addition. The condition at 5-year follow-up of all patients is reported and the facts associated with operative complications are analysed. Special attention was paid to the urological condition by performing urographies as a routine study both pre- and postoperatively. There was a strong correlation between the pathological postoperative urologic finding in regard to poor prognosis and permanent complications. Urinary tract infections occurred frequently and were difficult to handle. The operations performed for urological complications are listed. It is concluded that the treatment of carcinoma of the cervix uteri should be concentrated on clinics with a well-trained staff. At every stage of treatment intensive teamwork is most important. The rate of complications can be reduced by intensifying studies especially in the postoperative period. New diagnostic procedures and prophylactic measures should be tried andintroduced into routine practice if proved valuable. It is important that major surgery, such as radical hysterectomy, be performed in a teaching hospital for gynecologists.

Urological complications of okabayashi's operation for cervical cancer

“…Since 1939 the radical hysterectomy has been supplemented by consistent removal of the pelvic lymph nodes as performed by Meigs (8). The Wertheim-Meigs operation is more radical (1, 4, 5, 11, 13,14) but there is a significant number of serious urological complications (7,9,15,16). In recent decades a modified technique for radical hysterectomy, originally described by Okabayashi in 1921, has been used in different centers in an attempt to reduce the number and severity of urological complications (12).…”