Non-functional complications associated with radical hysterectomy

Abstract

Purpose: Bladder dysfunction is the most frequent complication after radical hysterectomy. However, there are other relevant complications associated with cervical cancer surgery much less reported in literature. The aim of this study was to evaluate the frequency of non-functional complications associated with radical hysterectomy and to determine if there is any risk factor associated with their appearance. Methods: A retrospective study was conducted, including consecutive patients diagnosed with early-stage cervical cancer who underwent radical hysterectomy at La Paz University Hospital from January 2005 to December 2019. Data from intraoperative, short-term, and long-term complications were collected. A multivariate analysis was performed in order to identify potential predictors of surgical complications. Results: A total of 111 patients were included. Intraoperative complications occurred in 13(11.7%) women. Multivariate analysis showed a greater risk of intraoperative complications if microscopic parametrial involvement was present (OR=16.7; 95%CI 1.4-195). 41(36.9%) patients had any short-term postoperative complication, being urological the most frequent ones. Lymphedema was the most frequent long-term complication and occurred in 20(18%) patients. In short-term and long-term univariate analysis, TNM histological tumor stage was tended to be associated (p=0.07) to short-term postoperative complications, and FIGO stage was significatively associated (p=0.05) to long-term postoperative complications. Conclusion: Urological complications are the most frequent ones after radical hysterectomy. However, other less frequent complications such as genitourinary fistula or lymphedema are also important due to their impact on the quality of life of patients. We found that parametrial involvement in the postoperative pathological analysis was associated with higher intraoperative complications rate.