Tohoku J. Exp. Med., 2024 May, 263(1)

Long-Term and Short-Interval Assessment of Self-Reported Urinary and Sexual Functions after Nerve-Sparing Radical Hysterectomy: A Prospective Cohort Study

Masumi Ishibashi,¹ Hitoshi Niikura,² Motoko Ishida,³ Noriyuki Iwama,^1,3 Hirohito Metoki,⁴ Shogo Shigeta,¹ Tomoyuki Nagai,⁵ Hideki Tokunaga,¹ Muneaki Shimada¹ and Nobuo Yaegashi¹

¹Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Miyagi, Japan
²Department of Obstetrics and Gynecology, National Hospital Organization Sendai Medical Center, Sendai, Miyagi, Japan
³Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
⁴Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Miyagi, Japan
⁵Department of Gynecology, Miyagi Cancer Center, Natori, Miyagi, Japan

The aim of this study was to determine the impact of nerve preservation confirmed by intraoperative electrical stimulation (IES) on subjective symptoms of urinary and sexual function in uterine cervical cancer patients who underwent radical hysterectomies. This study included 85 patients who underwent type C radical hysterectomy with IES. Pelvic splanchnic nerve preservation with IES after hysterectomy (nerve-stimulation positive group) was confirmed in 61 women and 24 women did not have nerve preservation (negative group). Urinary function was assessed with the Overactive Bladder Symptom Score (OABSS), International Prostate Symptom Score (IPSS), and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) questionnaires. Sexual function was surveyed using the Female Sexual Function Index (FSFI). Longitudinal changes in those scores according to response to nerve-stimulation were evaluated using a generalized estimating equation. IPSS quality of life (QOL) scores were significantly better in the nerve-stimulation positive group compared with the scores in the negative group until 12 months after surgery, whereas OABSS, IPSS total, IPSS voiding, and ICIQ-SF scores evaluating urinary symptoms were not significantly different between the two groups. FSFI scores were better in the nerve-stimulation positive group 36 months after surgery compared with the scores in the negative group. In this study, we assessed self-reported urinary and sexual symptoms after nerve-sparing radical hysterectomy (NSRH) with IES in the long term. We demonstrated that nerve-sparing significantly reduced distress associated with QOL until 1 year, improved urinary storage symptoms at 2 years, and sexual symptoms 3 years after surgery.

Key words —— bladder function; intraoperative electrical stimulation; nerve-preserving radical hysterectomy; sexual function; uterine cervical cancer

© 2024 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2024 May, 263(1), 1-9.

Correspondence: Hitoshi Niikura, M.D., Ph.D., Department of Obstetrics and Gynecology, National Hospital Organization Sendai Medical Center, 2-11-12 Miyagino, Sendai, Miyagi 983-8520, Japan.

E-mail: niikura@med.tohoku.ac.jp