Long Term Complications after Radical Hysterectomy with Pelvic Lymphadenectomy
Tarinee Manchana MD*, Nakarin Sirisabya MD*, Ruangsak Lertkhachonsuk MD*, Pongkasem Worasethsin MD*, Nipon Khemapech MD*, Tul Sittisomwong MD*, Apichai Vasuratna MD*, Wichai Termrungruanglert MD*, Damrong Tresukosol MD*
Affiliation : * Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Objective : To evaluate the incidence of long-term complications in stage IB and IIA cervical cancer patients
undergoing radical hysterectomy with bilateral pelvic lymphadenectomy
Material and Method: A retrospective review on 290 patients who were treated with primary type III radical
hysterectomy with bilateral pelvic lymphadenectomy between January 1, 1997 and December 31, 2005.
Long-term complications were classified in two categories, voiding dysfunction and complication from
lymphadenectomy such as lymphocyst and lymphedema.
Results : Forty-two patients (14.5%) required urethral catheterization more than four weeks. Only four
patients (1.4%) were diagnosed as neurogenic bladder and required permanent self-catheterization. Two
hundred forty eight patients (85.5%) returned to normal voiding within 1 month postoperatively. The
incidence of lymphocyst was 9.3%; however, almost of them were asymptomatic and resolved spontaneously
within a few months. Only four patients (1.4%) had complicated lymphocyst and required hospitalization with
intravenous antibiotic and drainage procedure. Six patients (2.1%) were diagnosed as lymphedema after
exclusion of deep vein thrombosis and recurrent cervical carcinoma. Pelvic lymph node metastasis and
postoperative adjuvant radiation were not significant risk factors for lymphocyst and lymphedema.
Conclusion : Radical hysterectomy with lymphadenectomy is the treatment of choice in stage IB and IIA
cervical cancer with excellent survival rate. However, there are long-term complications such as voiding
dysfunction, lymphocyst, and lymphedema. Although these complications are not life threatening, they can
affect the quality of life.
Keywords : Radical hysterectomy, Long term complication, Voiding dysfunction, Lymphocyst, Lymphedema
