Urodynamic Findings following Radiotherapy for Cervical Carcinoma

Abstract

Forty patients were assessed urodynamically 5 to 11 years after radiotherapy for cervical carcinoma and compared with 27 patients prior to treatment. The mean volume of first bladder sensation after radiotherapy was significantly lower than the mean volume before treatment, as was the mean maximum cystometric capacity. The mean filling detrusor pressure was higher after radiotherapy than before treatment. Unstable detrusor contractions were found only in the 12 symptomatic patients. There was a significant reduction in maximal urethral closure pressure and functional profile length in the post-radiotherapy group. Detrusor instability was a common finding following radiotherapy. The reduction in bladder capacity alone was not sufficient to account for the symptoms of frequency, urgency and urge incontinence.

Urinary symptoms and impact on quality of life in women after treatment for endometrial cancer

“…These complications include irritative bladder symptoms, stress incontinence, abnormal voiding function, and radiation cystitis [7, 8]. In cervical cancer, severe urinary complications requiring surgery and urinary diversion can present much later after completion of radiation treatment, with one study reporting an average onset of severe urinary symptoms 15 years after radiation treatment [8].…”

“…Perkin et al examined urodynamic findings in 40 women after radiation therapy as the primary treatment for cervical cancer (without hysterectomy) compared to 26 women newly diagnosed with cervical cancer prior to treatment [7]. These authors found a difference in maximum cystometric capacity (284.8 vs. 346.4 ml, p <0.02), detrusor pressure (13.9 vs. 4.2 cmH2O, p <0.01), and maximum urethral closure pressure (56.7 vs. 65.8 cmH2O, p <0.05) between the two groups of women.…”

Urinary Disturbance after Therapy for Cervical Cancer: Urodynamic Evaluation and β 2 -Agonist Medication

“…Therefore, urinary flow would be expected to be markedly reduced. Urinary incontinence is especially 368 K. Hamada et al common in women who have undergone radical surgery [10]. Urinary incontinence, as measured by the pad test, was more severe in the radical hysterectomy-only group than in the radiation therapy-only group, but urethral pressure was not significantly different between the two groups.…”

“…It is well known that the urethral pressure gradually decreases with aging [1,2,5]: patients in the radiation therapy-only group were older than the other groups. In addition, radiation-induced urethral change may also decrease the urethral pressure [10]. It is reported that radiation produces severe fibrosis of the bladder wall with smooth muscle degeneration [11], which may be attributed to the direct effects of radiation on the muscle cells and to ischemia following vascular damage of perivascular smooth muscle cells [12].…”

GAP‐43 immunoreactivity of subepithelial and detrusor muscle nerve fibres in patients with refractory idiopathic detrusor overactivity

“…Patients experiencing urgency, frequency or incontinence were excluded. In view of the 33% incidence of DO known to occur after previous pelvic irradiation [Parkin et al, 1988], such patients were also excluded.…”