Incidence of urologic co-morbidities after abdominal radical hysterectomy: a systematic review of clinical trials.
[OBJECTIVE] This study aimed to estimate the incidence of intra-operative, structural, and functional post-operative urologic complications associated with abdominal radical hysterectomy for cervical
- 연구 설계 meta-analysis
APA
Marucci da Silva GF, Pilger TL, Candido Dos Reis FJ (2026). Incidence of urologic co-morbidities after abdominal radical hysterectomy: a systematic review of clinical trials.. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 36(1), 102722. https://doi.org/10.1016/j.ijgc.2025.102722
MLA
Marucci da Silva GF, et al.. "Incidence of urologic co-morbidities after abdominal radical hysterectomy: a systematic review of clinical trials.." International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, vol. 36, no. 1, 2026, pp. 102722.
PMID
41259843
Abstract
[OBJECTIVE] This study aimed to estimate the incidence of intra-operative, structural, and functional post-operative urologic complications associated with abdominal radical hysterectomy for cervical cancer.
[METHODS] Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive search was conducted in PubMed, EMBASE, CINAHL, and Web of Science up to July 2025. Inclusion criteria were randomized trials including women with cervical cancer undergoing abdominal radical hysterectomy and reporting urologic complications. Data extraction and risk of bias assessment were independently performed by 2 reviewers. Urologic morbidities were classified as intra-operative, structural, and functional. Meta-analyses were conducted using random- or common-effects models, depending on heterogeneity.
[RESULTS] A total of 10 studies comprising 1247 patients were included. For intra-operative complications, the incidence of bladder injury was 0.2% (95% CI 0% to 1.2%) and of ureteral injury 0.3% (95% CI 0% to 1.1%), with low heterogeneity. In contrast, the rates of structural post-operative complications, such as genitourinary fistulas (0.3% to 5.7%) and ureteral obstruction or hydronephrosis (8.2% to 11%), and functional complications, including urinary retention or bladder atony (6.7% to 12.3%), and urinary incontinence (1.7% to 11%), were drawn from heterogeneous studies with variable definitions and assessments. Because of this substantial heterogeneity, these values should be interpreted only as descriptive ranges rather than precise pooled estimates. Accordingly, a meta-analysis was not performed for structural and functional complications.
[CONCLUSIONS] Abdominal radical hysterectomy is associated with a low incidence of intra-operative urologic injuries but a notable risk of structural and functional complications, particularly, in patients receiving adjuvant radiotherapy. These findings highlight the need for patient counseling, standardized outcome reporting, and strategies to minimize long-term genitourinary morbidity.
[REVIEW REGISTRATION] CRD420250484975.
[METHODS] Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive search was conducted in PubMed, EMBASE, CINAHL, and Web of Science up to July 2025. Inclusion criteria were randomized trials including women with cervical cancer undergoing abdominal radical hysterectomy and reporting urologic complications. Data extraction and risk of bias assessment were independently performed by 2 reviewers. Urologic morbidities were classified as intra-operative, structural, and functional. Meta-analyses were conducted using random- or common-effects models, depending on heterogeneity.
[RESULTS] A total of 10 studies comprising 1247 patients were included. For intra-operative complications, the incidence of bladder injury was 0.2% (95% CI 0% to 1.2%) and of ureteral injury 0.3% (95% CI 0% to 1.1%), with low heterogeneity. In contrast, the rates of structural post-operative complications, such as genitourinary fistulas (0.3% to 5.7%) and ureteral obstruction or hydronephrosis (8.2% to 11%), and functional complications, including urinary retention or bladder atony (6.7% to 12.3%), and urinary incontinence (1.7% to 11%), were drawn from heterogeneous studies with variable definitions and assessments. Because of this substantial heterogeneity, these values should be interpreted only as descriptive ranges rather than precise pooled estimates. Accordingly, a meta-analysis was not performed for structural and functional complications.
[CONCLUSIONS] Abdominal radical hysterectomy is associated with a low incidence of intra-operative urologic injuries but a notable risk of structural and functional complications, particularly, in patients receiving adjuvant radiotherapy. These findings highlight the need for patient counseling, standardized outcome reporting, and strategies to minimize long-term genitourinary morbidity.
[REVIEW REGISTRATION] CRD420250484975.
MeSH Terms
Humans; Hysterectomy; Female; Incidence; Postoperative Complications; Uterine Cervical Neoplasms; Urologic Diseases; Comorbidity; Intraoperative Complications; Randomized Controlled Trials as Topic