Radical Pelvic Surgery

Radical pelvic surgery is commonly utilized for the treatment of pelvic malignancy. Radical hysterectomy with bilateral pelvic lymphadenectomy is considered the standard of care for the treatment of early invasive cervical cancer, and radical prostatectomy is utilized for the surgical treatment of prostate cancer. Radical hysterectomy for the treatment of locally invasive cervical cancer (stage IB and IIA) involves removal of the uterus, the parametrium (which includes the round, uterosacral, broad, and cardinal ligaments), the upper third of the vagina, and commonly the pelvic lymph nodes. Radical prostatectomy for the treatment of localized prostate cancer involves removal of the prostate, seminal vesicles, and commonly pelvic lymph nodes and has been shown in clinical trials to reduce progression to metastasis and death from prostate cancer [1, 2]. The goals of radical prostatectomy are to eliminate cancer burden while at the same time preserving urinary control and sexual function [3]. Yet, despite the development of nerve sparing techniques and the use of robotic surgery, urinary symptoms may develop as a result of or persist despite these operations. The ensuing chapter seeks to characterize the symptoms and urodynamic findings demonstrated by patients after radical pelvic surgery.