Long-term functional sequelae of the urinary tract following radical surgical treatment of carcinoma of the cervix with and without extended radiation therapy
1992
Organic and functional lesions of the urinary tract following radical surgery and radiation therapy for gynecologic cancer are complications well known in the literature. The irreversible anatomic and neurologic damage, which often manifests itself many years after the original therapy, is the cause of serious pathology which affects the quality of life of cancer-free patients. In order to delineate those predisposing factors which if corrected or changed would permit the prevention or reduction of such complications, the authors report their experience in 20 patients who had undergone surgical treatment for carcinoma of the cervix, of whom 14 had radiation therapy at least 10 years prior to investigation. Problems of voiding and reduction of bladder compliance with an increase of detrusor pressure were mostly present in the irradiated patients. Low compliance and reflux was significantly correlated with deterioration of the upper urinary tract, especially in the presence of excessively high urethral pressures. The resulting problems are often difficult to treat owing to the diminished effectiveness of drugs and the possibility that surgical treatment may also be inadequate due to tissue damage. Follow-up studies of bladder function must be continued indefinitely so as to guarantee early recognition of alterations in the voiding phase and of occurrence of the ureterorenal reflux which can eventually compromise kidney function.
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