Projects / Programmes
NERVE-SPARING RADICAL HYSTERECTOMY
| Code |
Science |
Field |
Subfield |
| 3.05.00 |
Medical sciences |
Human reproduction |
|
| Code |
Science |
Field |
| B570 |
Biomedical sciences |
Obstetrics, gynaecology, andrology, reproduction, sexuality |
cervical cancer, radical hysterectomy, nerve-sparing, urodynamics, histologic analysis
Researchers (16)
Organisations (1)
Abstract
In Slovenia, the women with cervical cancer (FIGO stages IA2, IB, and IIA) are treated surgically. A new aspect of radical hysterectomy, emphasized in the last few years is the so-called »nerve sparing« technique, i.e. preservation of the lower urinary tract innervation, which essentially reduces mutilant consequences of surgery, leaving the function intact. Descriptions of the nerve sparing techniques are based on most recent anatomical findings on lower urinary tract innervation, and the Ljubljana group have gained some experience with it as well. Our aim is to improve the anatomical knowledge of pelvic innervation and further develop the surgical technique. Therefore, the women consenting to participate in the study will before surgery undergo standard urinary measurements, which will give us the insight into the functional features of the lower urinary tract prior to surgery. Should the procedure allow, we will prepare the posterior, lateral and anterior parametrium following the principles of the of nerve sparing technique. The amount of nerve fibers, contained in the resected parametria will be evaluated using special histologic staining (S-100). After surgery, we will follow the women’s recovery: duration of catheterization, possible retention of the urine, and we will repeat urodynamic measurements at 3–6 months, and at 12 months. The women planned for radiotherapy will be excluded. The analysis will involve a thorough comparison of the bladder function between the women in whom the nerve-sparing technique was used and those in whom it was not possible to use it; the bladder function will be compared in terms of the width of the vaginal cuff, and the amount of nerve fibers contained in the resected parametria analyzed. On the basis of obtained results we will be able to confirm or reject the opinions on innervation pathways of the lower urinary tract, improve our skills in using the »nerve sparing« surgical technique, and, possibly, suggest new standards for preparation of the posterior, lateral and anterior parametria at radical hysterectomy.
