Bladder and bowel symptoms in cervical and endometrial cancer survivors

Abstract

Objective Previous studies likely underestimate the prevalence of bowel and bladder symptoms in gynecologic cancer survivors. We sought to estimate the prevalence of these symptoms in cervical and endometrial cancer survivors who had completed treatment one year previously compared to non-cancer controls, and to examine factors associated with more severe symptoms in survivors. Methods As part of a larger quality of life study, survivors who were one-year post-treatment for cervical or endometrial cancer (n = 104) completed measures of bladder and bowel symptoms. An age- and race/ethnicity-matched sample of women with no history of cancer was recruited for comparison purposes. Results Survivors reported a higher prevalence of bladder symptoms, specifically storage and incontinence symptoms, than non-cancer controls. Prevalence rates for bowel symptoms in survivors were higher than those reported in previous studies. Greater symptom severity was associated with younger age, lower annual incomes and less education. Other correlates included higher body mass index and history of smoking. As hypothesized, more severe symptoms were associated with radical hysterectomy and pelvic radiation. Conclusions Bladder and bowel symptoms are more prevalent in cervical and endometrial cancer survivors than non-cancer controls. Future research should replicate these findings in a larger, prospective study.

Cervical Cancer Survivorship: Long-term Quality of Life and Social Support

“…Cervical cancer survivors commonly report late effects including bladder dysfunction 7-17 , bowel dysfunction 9,18,19 , sexual dysfunction 9,20-25 , lymphedema 3,9,14,26,27 and psychosocial problems. 28-30 Six studies were noted that have broadly addressed multiple aspects of quality of life in a substantial number of cervical cancer patients.…”

“…However, such symptoms were also common, albeit less common, in matched controls: 83.7% with storage problems and 66.4% with incontinence (p<0.05). 7 It has been well established that urinary incontinence significantly impacts quality of life and is associated with sexual dysfunction, social isolation, and work impairment as well as depression and anxiety. 39-41 There are additional urologic complications that impact quality of life that can occur after radiotherapy including dysuria, hematuria, ureteric stricture or stenosis, decreased bladder compliance, vesicovaginal or ureterovaginal fistula, and hemorrhagic cystitis.…”

Effect of Pelvic Floor Muscle Training on Urinary Incontinence in Gynecologic Cancer: A Review

“…Among gynecologic cancer patients SUI and UUI rates ranged from 30.8% [24] to 59.5% [23] and 13.9% [24] to 33.9% [23] before treatment, respectively. Among the gynecologic survivals, range of SUI reported from 24.3% [27] to 76% [25] while UUI reported from 9.3% [27] to 75% [25]. Regarding to type of treatment, Segal et al investigated the effect of radiation therapy as a risk factor of pelvic floor function and reported 21.0% SUI and 13% UUI prevalent among "radiation therapy" group while 24.1% SUI and 26.4% UUI reported in "No radiation" group which concluded there is no association between radiation and urinary incontinence (p >.05); whereas age (aOR=1.06, 95% CI 1.02-1.10) and BMI (aOR=1.07, 95% CI 1.02-1.11) significantly were observed as risk factors for UI.…”

Effects of radiation therapy on the structure and function of the pelvic floor muscles of patients with cancer in the pelvic area: a systematic review

“…Few articles measured the impacts of RT on the PFM structure or function in women treated for gynecological cancers, even though there are many studies reporting urinary, sexual, or fecal problems after radiotherapy versus surgery alone [4,6,9,12,11,3,52,53]. In this review, only two papers met our criteria and could be included.…”

“…Lesions such as stenosis, agglutination, or shortening of the vagina have been detailed for women after gynecological cancers [3]. Furthermore, a high prevalence of pelvic floor dysfunctions following radiotherapy for pelvic neoplasms has also been reported: urinary incontinence and urgency [4,5], sexual dysfunction and dyspareunia [6][7][8], and fecal urgency and incontinence [9,10]. Such dysfunctions have been demonstrated not only to cause distress to cancer survivors [11], but also to diminish their participation in activities of daily living and social activities, leading to an overall decreased quality of life [12].…”