Evaluation Of Pelvic Floor Functions After Laparoscopic Nerve-Sparing Radical Hysterectomy For Early-Stage Cervical Cancer

Objective: To evaluate the effect of laparoscopic nerve-sparing radical hysterectomy(LNSRH)on postoperative pelvic floor function in females with early-stage cervical cancer.Methods: Thirty-eight patients were selected with stage IB1～IIA1 cervical cancer in Shengjing Hospital Affiliated to China Medical University from December 2017 to July2019,who were randomly assigned to two groups.Finally thirty-four patients participated in all follow-up work,17 patients who underwent LNSRH as study group(LNSRH group)and 17 patients who underwent laparoscopic radical hysterectomy(LRH)as control group(LRH group).The general clinical data,surgical parameters,female sexual function index(FSFI)questionairs,the recovery of micturition function and defecation function between the two groups were analyzed.Results: No significant differences were found in general clinical data(age,BMI,FIGO staging,pathological type)and surgical parameters(operation time,estimated bleeding volume,number of resected pelvic lymph nodes,length of resected vagina).When compared with the LRH group,the LNSRH group had shorter hospital stay,shorter duration of the postoperative catheterization,shorter postoperative first anal exhaust time,less bladder post-void residual volume at the 14 th day after surgery,larger maximum flow rate at 3 months post-operation,higher anal maximal contraction pressure and lower first sensation volume by means of anorectal manometry at 3 months postoperatively,and the difference was statistically significant(P<0.05).However,there was no significant difference in the incidence of urinary system symptoms(11.77% vs35.29%)and digestive system symptoms(11.77% vs 23.53%)between LNSRH group and LRH group at 3 months after operation.The total score of FSFI and the score of sexual desire,sexual arouse,vaginal lubrication,orgasm and the degree of sexual satisfaction in the LNSRH group were higher than those in LRH group,but there was no significant difference in the score of algopareunia between the two groups.Conclusion: LNSRH is feasible as a surgical method for the treatment of early cervical cancer,which could promote the postoperative recovery of micturition function and defecation function and sexual function.