Systematic review: anal and rectal changes after radiotherapy for prostate cancer

Krol, Robin; Smeenk, Robert Jan; Lin, Emile N.J.T. van; Yeoh, Eric; Hopman, W. P. M.

doi:10.1007/s00384-013-1784-8

Cited by 64 publications

(48 citation statements)

References 52 publications

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“…), all generally point toward detrimental effects of RT on the PFM function. This is in concordance with what was observed by Krol et al [49] in their systematic review on anal and rectal after EBRT for prostate cancer, where decreased anal resting pressure was supported by low to moderate evidence. Lastly, the study by Allgayer et al [28] demonstrated no significant differences in PFM function.…”

Section: Effects Of Rt On the Pfm Functionsupporting

confidence: 93%

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

et al. 2015

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PurposeRadiation therapy (RT) is often recommended in the treatment of pelvic cancers. Following RT, a high prevalence of pelvic floor dysfunctions (urinary incontinence, dyspareunia, and fecal incontinence) is reported. However, changes in pelvic floor muscles (PFMs) after RT remain unclear. The purpose of this review was to systematically document the effects of RT on the PFM structure and function in patients with cancer in the pelvic area.

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Section: Effects Of Rt On the Pfm Functionsupporting

confidence: 93%

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

et al. 2015

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“…FI in men who generally have fecal soiling or leakage rather than gross incontinence may be associated with normal sphincteric function 63–67 ; iatrogenic anal injury (eg, after perianal procedures); or dyssynergic defecation, 68 wherein high anal resting pressure entraps feces during defecation and subsequently expels them 69 ; radiation therapy 70 ; or isolated weakness of the internal anal sphincter.…”

Section: F1 Fecal Incontinencementioning

confidence: 99%

Anorectal Disorders

et al. 2016

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This report defines criteria and reviews the epidemiology, pathophysiology, and management of the following common anorectal disorders: fecal incontinence (FI), functional anorectal pain, and functional defecation disorders. FI is defined as the recurrent uncontrolled passage of fecal material for at least 3 months. The clinical features of FI are useful for guiding diagnostic testing and therapy. Anorectal manometry and imaging are useful for evaluating anal and pelvic floor structure and function. Education, antidiarrheals, and biofeedback therapy are the mainstay of management; surgery may be useful in refractory cases. Functional anorectal pain syndromes are defined by clinical features and categorized into 3 subtypes. In proctalgia fugax, the pain is typically fleeting and lasts for seconds to minutes. In levator ani syndrome and unspecified anorectal pain, the pain lasts more than 30 minutes, but in levator ani syndrome there is puborectalis tenderness. Functional defecation disorders are defined by ≥2 symptoms of chronic constipation or irritable bowel syndrome with constipation, and with ≥2 features of impaired evacuation, that is, abnormal evacuation pattern on manometry, abnormal balloon expulsion test, or impaired rectal evacuation by imaging. It includes 2 subtypes: dyssynergic defecation and inadequate defecatory propulsion. Pelvic floor biofeedback therapy is effective for treating levator ani syndrome and defecatory disorders.

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“…increased frequency and urgency of defecation, faecal incontinence and rectal bleeding). [22] High dose RT to the rectal wall can lead to anatomical and functional damage including telangectasia, mucosal congestion, ulceration and fibrosis [23] with associated impairment of sensation, compliance and capacity. [24] Similarly, irradiation of the anal sphincter complex may impair function.…”

Section: Radical Therapiesmentioning

confidence: 99%