İlker SELÇUKa, İlkan TATARb, Emre HURİc Tayfun GÜNGÖRa aDepartment of Gynecologic Oncology, Health Sciences University, Zekai Tahir Burak Woman?s Health Training and Research Hospital, Departments of bAnatomy, cUrology, Hacettepe University Faculty of Medicine, Ankara, TURKEY
DOI: 10.5336/jcog.2018-63397 Article Language: EN 136 Viewed -- 156 Downloaded
ABSTRACT Radical hysterectomy is a surgery performed to excise all the peri-cervical tissues that have been affected by the spread of cervical carcinoma. During this procedure, the pelvic autonomic nerves are mostly injured due to the resection of ventral, caudal and lateral parts of parametrium, thus resulting in deficiencies of urologic, anorectal, and sexual functions. The urologic complications, especially bladder atony, lead to the most common surgical morbidity. Superior hypogastric plexus, hypogastric nerve, pelvic splanchnic nerves, and inferior hypogastric plexus provide sympathetic and parasympathetic innervation to the pelvic viscera. Selective protection of these nerves would definitely improve bladder functions; this approach is known as a nerve-sparing radical hysterectomy. A detailed knowledge of pelvic autonomic nerves, with regard to anatomical and clinical perspective, will improve the surgical outcomes.