OBJECTIVE: Voiding dysfunctions represent a leading morbidity after radical hysterectomy performed in patients with early-stage cervical cancer. The aim of this study was to perform ad hoc analysis of factors influencing voiding recovery in SENTIX (SENTinel lymph node biopsy in cervIX cancer) trial. METHODS: The SENTIX trial (47 sites, 18 countries) is a prospective study on sentinel lymph node biopsy without pelvic lymphadenectomy in patients with early-stage cervical cancer. Overall, the data of 300 patients were analysed. Voiding recovery was defined as the number of days from surgery to bladder catheter/epicystostomy removal or to post-voiding urine residuum ≤50 mL. RESULTS: The median voiding recovery time was three days (5th-95th percentile: 0-21): 235 (78.3%) patients recovered in <7 days and 293 (97.7%) in <30 days. Only seven (2.3%) patients recovered after >30 days. In the multivariate analysis, only previous pregnancy (p = 0.033) and type of parametrectomy (p < 0.001) significantly influenced voiding recovery >7 days post-surgery. Type-B parametrectomy was associated with a higher risk of delayed voiding recovery than type-C1 (OR = 4.69; p = 0.023 vs. OR = 3.62; p = 0.052, respectively), followed by type-C2 (OR = 5.84; p = 0.011). Both previous pregnancy and type C2 parametrectomy independently prolonged time to voiding recovery by two days. CONCLUSIONS: Time to voiding recovery is significantly related to previous pregnancy and type of parametrectomy but it is not influenced by surgical approach (open vs minimally invasive), age, or BMI. Type B parametrectomy, without direct visualisation of nerves, was associated with longer recovery than nerve-sparing type C1. Importantly, voiding dysfunctions after radical surgery are temporary, and the majority of the patients recover in less than 30 days, including patients after C2 parametrectomy.

Departamento de Obstetricia y Ginecología Hospital Clínico San Carlos Madrid Spain

Department of Gynaecology and Obstetrics Hospital Español de Buenos Aires Buenos Aires Argentina

Department of Gynaecology Institute of Oncology Angel H Roffo University of Bueno s Aires Buenos Aires Argentina

Department of Gynaecology Universite catholique de Louvain Cliniques Universitaires St Luc 1200 Brussels Belgium

Department of Obstetrics and Gynaecology Bata Hospital Zlin Czech Republic CEEGOG Zlin Czech Republic

Department of Obstetrics and Gynaecology Cantonal Hospital of Lucerne Lucerne Switzerland

Department of Obstetrics and Gynaecology Institute of Mother and Child Warsaw Poland

Department of Obstetrics and Gynaecology St Pierre University Hospital Université Libre de Bruxelles Brussels Belgium

Department of Obstetrics and Gynaecology University Hospital Ostrava Ostrava Poruba Czech Republic

Department of Special Operative and Oncologic Gynaecology Asklepios Clinic Hamburg Hamburg Germany

Gynaecologic Oncology Centre Department of Obstetrics and Gynaecology 1st Faculty of Medicine Charles University and General University Hospital CEEGOG Prague Czech Republic

Gynaecologic Oncology Unit La Paz University Hospital IdiPAZ Madrid Spain

Gynaecology Medical University of Graz Graz Austria

Gynecologic Oncology Unit MD Anderson Cancer Centre Madrid Spain

Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Republic

Institute of Obstetrics and Gynaecology Faculty of Medicine University of Debrecen Debrecen Hungary

Oncology Institute of East Slovakia Košice Slovakia

Unit of Gynaecological Oncology Institute Clinic of Gynaecology Obstetrics and Neonatology Hospital Clinic of Barcelona Barcelona Spain

References provided by Crossref.org

Sentinel lymph node biopsy without systematic pelvic lymphadenectomy in females with early-stage cervical cancer: final outcome of the SENTIX prospective, single-arm, noninferiority, international trial