Skip to main content
Erschienen in: Current Bladder Dysfunction Reports 2/2016

01.06.2016 | Cancer-Associated Voiding Dysfunction (A Peterson, Section Editor)

Incontinence, Voiding Dysfunction, and Other Urologic Complications After Radiotherapy for Gynecologic Malignancies

verfasst von: Garrick Greear, Carolyn Lefkowits, Lisa M. Parrillo, Brian J. Flynn

Erschienen in: Current Bladder Dysfunction Reports | Ausgabe 2/2016

Einloggen, um Zugang zu erhalten

Abstract

Women with newly diagnosed gynecologic cancer will undergo treatment with surgery, radiation, or combination therapy. A considerable proportion of these women will develop urologic complications including urinary incontinence, urinary retention, radiation cystitis, ureteral stricture, or genitourinary fistula. Diagnosis is typically made with a careful history, physical exam, endoscopy, urodynamics, and imaging. Non-surgical and surgical management of urologic complications following radiotherapy is complicated by local tissue damage resulting in inferior success rates when compared to the general population. It is imperative that the patient and physician understand the complexity of treatment and manage expectations accordingly.
Literatur
1.•
Zurück zum Zitat Erekson EA, Sung VW, DiSilvestro PA, Myers DL. Urinary symptoms and impact on quality of life in women after treatment for endometrial cancer. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(2):159–63. doi:10.1007/s00192-008-0755-z. Study using validated questionnaires that shows worse LUTD in irradiated patients. Erekson EA, Sung VW, DiSilvestro PA, Myers DL. Urinary symptoms and impact on quality of life in women after treatment for endometrial cancer. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(2):159–63. doi:10.​1007/​s00192-008-0755-z. Study using validated questionnaires that shows worse LUTD in irradiated patients.
3.
Zurück zum Zitat Keys HM, Roberts JA, Brunetto VL, Zaino RJ, Spirtos NM, Bloss JD, et al. A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a gynecologic oncology group study. Gynecol Oncol. 2004;92(3):744–51. doi:10.1016/j.ygyno.2003.11.048.CrossRefPubMed Keys HM, Roberts JA, Brunetto VL, Zaino RJ, Spirtos NM, Bloss JD, et al. A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a gynecologic oncology group study. Gynecol Oncol. 2004;92(3):744–51. doi:10.​1016/​j.​ygyno.​2003.​11.​048.CrossRefPubMed
4.
Zurück zum Zitat Creutzberg CL, van Putten WL, Koper PC, Lybeert ML, Jobsen JJ, Wárlám-Rodenhuis CC, et al. Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. Lancet. 2000;355(9213):1404–11. doi:10.1016/S0140-6736(00)02139-5.CrossRefPubMed Creutzberg CL, van Putten WL, Koper PC, Lybeert ML, Jobsen JJ, Wárlám-Rodenhuis CC, et al. Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. Lancet. 2000;355(9213):1404–11. doi:10.​1016/​S0140-6736(00)02139-5.CrossRefPubMed
5.
Zurück zum Zitat Nout RA, Smit VT, Putter H, Jürgenliemk-Schulz IM, Jobsen JJ, Lutgens LC, et al. Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial. Lancet. 2010;375(9717):816–23. doi:10.1016/S0140-6736(09)62163-2.CrossRefPubMed Nout RA, Smit VT, Putter H, Jürgenliemk-Schulz IM, Jobsen JJ, Lutgens LC, et al. Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial. Lancet. 2010;375(9717):816–23. doi:10.​1016/​S0140-6736(09)62163-2.CrossRefPubMed
9.
Zurück zum Zitat Sedlis A, Bundy BN, Rotman MZ, Lentz SS, Muderspach LI, Zaino RJ. A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: a Gynecologic Oncology Group study. Gynecol Oncol. 1999;73.2:177–83. doi:10.1006/gyno.1999.5387.CrossRef Sedlis A, Bundy BN, Rotman MZ, Lentz SS, Muderspach LI, Zaino RJ. A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: a Gynecologic Oncology Group study. Gynecol Oncol. 1999;73.2:177–83. doi:10.​1006/​gyno.​1999.​5387.CrossRef
10.
Zurück zum Zitat Delgado G, Bundy B, Zaino R, Sevin BU, Creasman WT, Major F. Prospective surgical-pathological study of disease-free interval in patients with stage IB squamous cell carcinoma of the cervix: a Gynecologic Oncology Group study. Gynecol Oncol. 1990;38(3):352–7.CrossRefPubMed Delgado G, Bundy B, Zaino R, Sevin BU, Creasman WT, Major F. Prospective surgical-pathological study of disease-free interval in patients with stage IB squamous cell carcinoma of the cervix: a Gynecologic Oncology Group study. Gynecol Oncol. 1990;38(3):352–7.CrossRefPubMed
13.
Zurück zum Zitat Berek JS, Hacker NF. Gynecologic oncology. 6th ed. Philadelphia: Wolters Kluwer; 2015. Berek JS, Hacker NF. Gynecologic oncology. 6th ed. Philadelphia: Wolters Kluwer; 2015.
15.
Zurück zum Zitat Heaps JM, Fu YS, Montz FJ, Hacker NF, Berek JS. Surgical-pathologic variables predictive of local recurrence in squamous cell carcinoma of the vulva. Gynecol Oncol. 1990;38(3):309–14.CrossRefPubMed Heaps JM, Fu YS, Montz FJ, Hacker NF, Berek JS. Surgical-pathologic variables predictive of local recurrence in squamous cell carcinoma of the vulva. Gynecol Oncol. 1990;38(3):309–14.CrossRefPubMed
16.
Zurück zum Zitat Mahner S, Jueckstock J, Hilpert F, Neuser P, Harter P, de Gregorio N, Hasenburg A, Sehouli J, Habermann A, Hillemanns P, Fuerst S. Adjuvant therapy in lymph node-positive vulvar cancer: the AGO-CaRE-1 study. J Ntnl Cancer Inst. 2015: 107.3. doi:10.1093/jnci/dju426. Mahner S, Jueckstock J, Hilpert F, Neuser P, Harter P, de Gregorio N, Hasenburg A, Sehouli J, Habermann A, Hillemanns P, Fuerst S. Adjuvant therapy in lymph node-positive vulvar cancer: the AGO-CaRE-1 study. J Ntnl Cancer Inst. 2015: 107.3. doi:10.​1093/​jnci/​dju426.
20.
Zurück zum Zitat Kuettel MR, Parda DS, Harter WK, Rodgers JE, Lynch JH. Treatment of female urethral carcinoma in medically inoperable patients using external beam irradiation and high dose rate intracavitary brachytherapy. J Urol. 1997;157(5):1669–71.CrossRefPubMed Kuettel MR, Parda DS, Harter WK, Rodgers JE, Lynch JH. Treatment of female urethral carcinoma in medically inoperable patients using external beam irradiation and high dose rate intracavitary brachytherapy. J Urol. 1997;157(5):1669–71.CrossRefPubMed
21.
Zurück zum Zitat Dalbagni G, Donat SM, Eschwege P, Herr HW, Zelefsky MJ. Results of high dose rate brachytherapy, anterior pelvic exenteration and external beam radiotherapy for carcinoma of the female urethra. J Urol. 2001;166(5):1759–61.CrossRefPubMed Dalbagni G, Donat SM, Eschwege P, Herr HW, Zelefsky MJ. Results of high dose rate brachytherapy, anterior pelvic exenteration and external beam radiotherapy for carcinoma of the female urethra. J Urol. 2001;166(5):1759–61.CrossRefPubMed
22.
Zurück zum Zitat Dayyani F, Hoffman K, Eifel P, Guo C, Vikram R, Pagliaro LC, et al. Management of advanced primary urethral carcinomas. BJU Int. 2014;114(1):25–31.CrossRefPubMed Dayyani F, Hoffman K, Eifel P, Guo C, Vikram R, Pagliaro LC, et al. Management of advanced primary urethral carcinomas. BJU Int. 2014;114(1):25–31.CrossRefPubMed
23.
Zurück zum Zitat Garden AS, Zagars GK, Delclos L. Primary carcinoma of the female urethra results of radiation therapy. Cancer. 1993;71(10):3102–8.CrossRefPubMed Garden AS, Zagars GK, Delclos L. Primary carcinoma of the female urethra results of radiation therapy. Cancer. 1993;71(10):3102–8.CrossRefPubMed
24.
Zurück zum Zitat Chen LA, Kim J, Boucher K, Terakedis B, Williams B, Nickman NA, et al. Toxicity and cost-effectiveness analysis of intensity modulated radiation therapy versus 3-dimensional conformal radiation therapy for postoperative treatment of gynecologic cancers. Gynecol Oncol. 2015;136(3):521–8.CrossRefPubMed Chen LA, Kim J, Boucher K, Terakedis B, Williams B, Nickman NA, et al. Toxicity and cost-effectiveness analysis of intensity modulated radiation therapy versus 3-dimensional conformal radiation therapy for postoperative treatment of gynecologic cancers. Gynecol Oncol. 2015;136(3):521–8.CrossRefPubMed
28.
29.
Zurück zum Zitat Korfage IJ, Essink-Bot ML, Mols F, van de Poll-Franse L, Kruitwagen R, van Ballegooijen M. Health-related quality of life in cervical cancer survivors: a population-based survey. Int J Radiat Oncol Biol Phys. 2009;73(5):1501–9.CrossRefPubMed Korfage IJ, Essink-Bot ML, Mols F, van de Poll-Franse L, Kruitwagen R, van Ballegooijen M. Health-related quality of life in cervical cancer survivors: a population-based survey. Int J Radiat Oncol Biol Phys. 2009;73(5):1501–9.CrossRefPubMed
30.••
Zurück zum Zitat Nout RA, van de Poll-Franse LV, Lybeert ML, Wárlám-Rodenhuis CC, Jobsen JJ, Mens JW, et al. Long-term outcome and quality of life of patients with endometrial carcinoma treated with or without pelvic radiotherapy in the post operative radiation therapy in endometrial carcinoma 1 (PORTEC-1) trial. J Clin Oncol. 2011;29(13):1692–700. Randomized controlled trial showing increased LUTD in irradiated patients, specifically increased incontinence. Nout RA, van de Poll-Franse LV, Lybeert ML, Wárlám-Rodenhuis CC, Jobsen JJ, Mens JW, et al. Long-term outcome and quality of life of patients with endometrial carcinoma treated with or without pelvic radiotherapy in the post operative radiation therapy in endometrial carcinoma 1 (PORTEC-1) trial. J Clin Oncol. 2011;29(13):1692–700. Randomized controlled trial showing increased LUTD in irradiated patients, specifically increased incontinence.
31.
Zurück zum Zitat Marks LB, Carroll PR, Dugan TC, Anscher MS. The response of the urinary bladder, urethra, and ureter to radiation and chemotherapy. Int J Radiat Oncol Biol Phys. 1995;31(5):1257–80.CrossRefPubMed Marks LB, Carroll PR, Dugan TC, Anscher MS. The response of the urinary bladder, urethra, and ureter to radiation and chemotherapy. Int J Radiat Oncol Biol Phys. 1995;31(5):1257–80.CrossRefPubMed
32.
Zurück zum Zitat Perez CA, Brady LW (Eds.), Principles and practice of radiation oncology (3rd ed.), Lippincott-Raven, Philadelphia. 1998: 1733–1834. Perez CA, Brady LW (Eds.), Principles and practice of radiation oncology (3rd ed.), Lippincott-Raven, Philadelphia. 1998: 1733–1834.
33.
Zurück zum Zitat Levenback C, Eifel PJ, Burke TW, Morris M, Gershenson DM. Hemorrhagic cystitis following radiotherapy for stage Ib cancer of the cervix. Gynecol Oncol. 1994;55(2):206–10.CrossRefPubMed Levenback C, Eifel PJ, Burke TW, Morris M, Gershenson DM. Hemorrhagic cystitis following radiotherapy for stage Ib cancer of the cervix. Gynecol Oncol. 1994;55(2):206–10.CrossRefPubMed
34.
Zurück zum Zitat Antonakopoulos GN, Hicks RM, Berry RJ. The subcellular basis of damage to the human urinary bladder induced by irradiation. J Pathol. 1984;143(2):103–16.CrossRefPubMed Antonakopoulos GN, Hicks RM, Berry RJ. The subcellular basis of damage to the human urinary bladder induced by irradiation. J Pathol. 1984;143(2):103–16.CrossRefPubMed
35.
Zurück zum Zitat Thiruchelvam N, Cruz F, Kirby M, Tubaro A, Chapple C, Sievert KD. A review of detrusor overactivity and the overactive bladder after radical prostate cancer treatment. BJU Int. 2015;116(6):853–61. doi:10.1111/bju.13078.CrossRefPubMed Thiruchelvam N, Cruz F, Kirby M, Tubaro A, Chapple C, Sievert KD. A review of detrusor overactivity and the overactive bladder after radical prostate cancer treatment. BJU Int. 2015;116(6):853–61. doi:10.​1111/​bju.​13078.CrossRefPubMed
37.••
Zurück zum Zitat de Boer SM, Nout RA, Jürgenliemk-Schulz IM, Jobsen JJ, Lutgens LC, van der Steen-Banasik EM, et al. Long-term impact of endometrial cancer diagnosis and treatment on health-related quality of life and cancer survivorship: results from the randomized PORTEC-2 trial. Int J Radiat Oncol Biol Phys. 2015;93(4):797–809. doi:10.1016/j.ijrobp.2015.08.023. Randomized controlled trial showing OAB and incontinence in patients treated with both EBRT and brachytherapy. de Boer SM, Nout RA, Jürgenliemk-Schulz IM, Jobsen JJ, Lutgens LC, van der Steen-Banasik EM, et al. Long-term impact of endometrial cancer diagnosis and treatment on health-related quality of life and cancer survivorship: results from the randomized PORTEC-2 trial. Int J Radiat Oncol Biol Phys. 2015;93(4):797–809. doi:10.​1016/​j.​ijrobp.​2015.​08.​023. Randomized controlled trial showing OAB and incontinence in patients treated with both EBRT and brachytherapy.
38.
Zurück zum Zitat Herwig R, Bruns F, Strasser H, Pinggera GM, Micke O, Rehder P, et al. Late urologic effects after adjuvant irradiation in stage I endometrial carcinoma. Urology. 2004;63(2):354–8.CrossRefPubMed Herwig R, Bruns F, Strasser H, Pinggera GM, Micke O, Rehder P, et al. Late urologic effects after adjuvant irradiation in stage I endometrial carcinoma. Urology. 2004;63(2):354–8.CrossRefPubMed
39.•
Zurück zum Zitat Wein AJ. Pathophysiology and classification of lower urinary tract dysfunction. 11th ed. Philadelphia: Elsevier; 2016. p. 1685–96. Describes established classification system for incontinence. Wein AJ. Pathophysiology and classification of lower urinary tract dysfunction. 11th ed. Philadelphia: Elsevier; 2016. p. 1685–96. Describes established classification system for incontinence.
40.
Zurück zum Zitat Parkin DE, Davis JA, Symonds RP. Urodynamic findings following radiotherapy for cervical carcinoma. Br J Urol. 1988;61(3):213–7.CrossRefPubMed Parkin DE, Davis JA, Symonds RP. Urodynamic findings following radiotherapy for cervical carcinoma. Br J Urol. 1988;61(3):213–7.CrossRefPubMed
41.
Zurück zum Zitat Katepratoom C, Manchana T, Amornwichet N. Lower urinary tract dysfunction and quality of life in cervical cancer survivors after concurrent chemoradiation versus radical hysterectomy. Int Urogynecol J. 2014;25(1):91–6. doi:10.1007/s00192-013-2151-6.CrossRefPubMed Katepratoom C, Manchana T, Amornwichet N. Lower urinary tract dysfunction and quality of life in cervical cancer survivors after concurrent chemoradiation versus radical hysterectomy. Int Urogynecol J. 2014;25(1):91–6. doi:10.​1007/​s00192-013-2151-6.CrossRefPubMed
42.
Zurück zum Zitat Lin HH, Sheu BC, Lo MC, Huang SC. Abnormal urodynamic findings after radical hysterectomy or pelvic irradiation for cervical cancer. Int J Gynecol Obstet. 1998;63(2):169–74.CrossRef Lin HH, Sheu BC, Lo MC, Huang SC. Abnormal urodynamic findings after radical hysterectomy or pelvic irradiation for cervical cancer. Int J Gynecol Obstet. 1998;63(2):169–74.CrossRef
43.
Zurück zum Zitat Gilbaz E, Gungor UF, Aslay I, Yalcin O. The effects of simple and radical hysterectomy and radiotherapy on lower urinary tract symptoms and urodynamics. Eur J Gynaecol Oncol. 2012;34(3):248–53. Gilbaz E, Gungor UF, Aslay I, Yalcin O. The effects of simple and radical hysterectomy and radiotherapy on lower urinary tract symptoms and urodynamics. Eur J Gynaecol Oncol. 2012;34(3):248–53.
45.
Zurück zum Zitat Flores D, Mock S, Broghammer JA, Griebling TL, Dmochowski RR, Padmanabhan P. Onabotulinumtoxin A in patients with a history of prior pelvic radiation therapy. Annual Society of Female Urology and Urodynamics, Scottsdale, AZ, February 2015 and Annual American Urologic Association meeting, New Orleans. 2015. Flores D, Mock S, Broghammer JA, Griebling TL, Dmochowski RR, Padmanabhan P. Onabotulinumtoxin A in patients with a history of prior pelvic radiation therapy. Annual Society of Female Urology and Urodynamics, Scottsdale, AZ, February 2015 and Annual American Urologic Association meeting, New Orleans. 2015.
46.
Zurück zum Zitat Flynn BJ, Yap WT. Pubovaginal sling using allograft fascia lata versus autograft fascia for all types of stress urinary incontinence: 2-year minimum followup. J Urol. 2002;167(2):608–12.CrossRefPubMed Flynn BJ, Yap WT. Pubovaginal sling using allograft fascia lata versus autograft fascia for all types of stress urinary incontinence: 2-year minimum followup. J Urol. 2002;167(2):608–12.CrossRefPubMed
47.
Zurück zum Zitat Thomas K, Venn SN, Mundy AR. Outcome of the artificial urinary sphincter in female patients. J Urol. 2002;167(4):1720–2.CrossRefPubMed Thomas K, Venn SN, Mundy AR. Outcome of the artificial urinary sphincter in female patients. J Urol. 2002;167(4):1720–2.CrossRefPubMed
48.
Zurück zum Zitat Angioli R, Penalver M, Muzii L, Mendez L, Mirhashemi R, Bellati F, et al. Guidelines of how to manage vesicovaginal fistula. Crit Rev Oncol/Hematol. 2003;48(3):295–304.CrossRef Angioli R, Penalver M, Muzii L, Mendez L, Mirhashemi R, Bellati F, et al. Guidelines of how to manage vesicovaginal fistula. Crit Rev Oncol/Hematol. 2003;48(3):295–304.CrossRef
49.
Zurück zum Zitat Zoubek J, McGuire EJ, Noll F, DeLancey JO. The late occurrence of urinary tract damage in patients successfully treated by radiotherapy for cervical carcinoma. J Urol. 1989;141(6):1347–9.PubMed Zoubek J, McGuire EJ, Noll F, DeLancey JO. The late occurrence of urinary tract damage in patients successfully treated by radiotherapy for cervical carcinoma. J Urol. 1989;141(6):1347–9.PubMed
50.
Zurück zum Zitat Narayanan P, Nobbenhuis M, Reynolds KM, Sahdev A, Reznek RH, Rockall AG. Fistulas in malignant gynecologic disease: etiology, imaging, and management. Radiographics. 2009;29(4):1073–83.CrossRefPubMed Narayanan P, Nobbenhuis M, Reynolds KM, Sahdev A, Reznek RH, Rockall AG. Fistulas in malignant gynecologic disease: etiology, imaging, and management. Radiographics. 2009;29(4):1073–83.CrossRefPubMed
51.
Zurück zum Zitat Abrams, P., De Vries, C., Elneil, S., Emasu, A., Esegbono, G., Gueye, S., Mohammad, R., Mourad, S., Hilton, P., Pickard, R., Stanford, E.. Fistula: In Abrams P, Cardozo L, Khoury S, Wein A (Eds.): Incontinence: Proceedings from the 5th International Consultation on Incontinence. Plymouth UK: Health Publications, 2013, pp.1529-1568 Abrams, P., De Vries, C., Elneil, S., Emasu, A., Esegbono, G., Gueye, S., Mohammad, R., Mourad, S., Hilton, P., Pickard, R., Stanford, E.. Fistula: In Abrams P, Cardozo L, Khoury S, Wein A (Eds.): Incontinence: Proceedings from the 5th International Consultation on Incontinence. Plymouth UK: Health Publications, 2013, pp.1529-1568
52.•
Zurück zum Zitat Pshak T, Nikolavsky D, Terlecki R, Flynn BJ. Is tissue interposition always necessary in transvaginal repair of benign, recurrent vesicovaginal fistulae? Urology. 2013;82(3):707–12. doi:10.1016/j.urology.2013.03.076. Retrospective review discussing need for tissue interposition in vesicovaginal fistula repair. Pshak T, Nikolavsky D, Terlecki R, Flynn BJ. Is tissue interposition always necessary in transvaginal repair of benign, recurrent vesicovaginal fistulae? Urology. 2013;82(3):707–12. doi:10.​1016/​j.​urology.​2013.​03.​076. Retrospective review discussing need for tissue interposition in vesicovaginal fistula repair.
54.
Zurück zum Zitat McLntyre JF, Eifel PJ, Levenback C, Oswald MJ. Ureteral stricture as a late complication of radiotherapy for stage IB carcinoma of the uterine cervix. Cancer. 1995;75(3):836–43.CrossRef McLntyre JF, Eifel PJ, Levenback C, Oswald MJ. Ureteral stricture as a late complication of radiotherapy for stage IB carcinoma of the uterine cervix. Cancer. 1995;75(3):836–43.CrossRef
55.
Zurück zum Zitat Windsperger A, Larke R, Higuchi T, Maroni P, Flynn B. PD3-09 ureteral reconstruction or benign stricture disease: a single institution 11 year experience with simple and complex reconstructive techniques. J Urol. 2014;4(191), e23.CrossRef Windsperger A, Larke R, Higuchi T, Maroni P, Flynn B. PD3-09 ureteral reconstruction or benign stricture disease: a single institution 11 year experience with simple and complex reconstructive techniques. J Urol. 2014;4(191), e23.CrossRef
56.
Zurück zum Zitat Cochrane JP, Yarnold JR, Slack WW. The surgical treatment of radiation injuries after radiotherapy for uterine carcinoma. Br J Surg. 1981;68(1):25–8.CrossRefPubMed Cochrane JP, Yarnold JR, Slack WW. The surgical treatment of radiation injuries after radiotherapy for uterine carcinoma. Br J Surg. 1981;68(1):25–8.CrossRefPubMed
57.
Zurück zum Zitat Wilkin M, Horwitz G, Seetharam A, Hartenbach E, Schink JC, Bruskewitz R, Jarrard DF. Long-term complications associated with the Indiana pouch urinary diversion in patients with recurrent gynecologic cancers after high-dose radiation. In Urologic Oncology: Seminars and Original Investigations 2005; 23(1): 12–15. Elsevier. Wilkin M, Horwitz G, Seetharam A, Hartenbach E, Schink JC, Bruskewitz R, Jarrard DF. Long-term complications associated with the Indiana pouch urinary diversion in patients with recurrent gynecologic cancers after high-dose radiation. In Urologic Oncology: Seminars and Original Investigations 2005; 23(1): 12–15. Elsevier.
58.
Zurück zum Zitat Kisner CD, Kesner KM. Use of the transverse colon conduit for vesicovaginal fistula in late‐stage carcinoma of the cervix. Br J Urol. 1987;59(3):234–8.CrossRefPubMed Kisner CD, Kesner KM. Use of the transverse colon conduit for vesicovaginal fistula in late‐stage carcinoma of the cervix. Br J Urol. 1987;59(3):234–8.CrossRefPubMed
59.
Zurück zum Zitat Maier U, Ehrenbock PM, Hofbauer J. Late urological complications and malignancies after curative radiotherapy for gynecological carcinomas: a retrospective analysis of 10,709 patients. J Urol. 1997;158(3):814–7.CrossRefPubMed Maier U, Ehrenbock PM, Hofbauer J. Late urological complications and malignancies after curative radiotherapy for gynecological carcinomas: a retrospective analysis of 10,709 patients. J Urol. 1997;158(3):814–7.CrossRefPubMed
60.
Zurück zum Zitat Arai T, Nakano T, Fukuhisa K, Kasamatsu T, Tsunematsu R, Masubuchi K, et al. Second cancer after radiation therapy for cancer of the uterine cervix. Cancer. 1991;67(2):398–405.CrossRefPubMed Arai T, Nakano T, Fukuhisa K, Kasamatsu T, Tsunematsu R, Masubuchi K, et al. Second cancer after radiation therapy for cancer of the uterine cervix. Cancer. 1991;67(2):398–405.CrossRefPubMed
61.
Zurück zum Zitat Duncan RE, Bennett DW, Evans AT, Aron BS, Schellhas HF. Radiation-induced bladder tumors. J Urol. 1977;118(1):43–5.PubMed Duncan RE, Bennett DW, Evans AT, Aron BS, Schellhas HF. Radiation-induced bladder tumors. J Urol. 1977;118(1):43–5.PubMed
Metadaten
Titel
Incontinence, Voiding Dysfunction, and Other Urologic Complications After Radiotherapy for Gynecologic Malignancies
verfasst von
Garrick Greear
Carolyn Lefkowits
Lisa M. Parrillo
Brian J. Flynn
Publikationsdatum
01.06.2016
Verlag
Springer US
Erschienen in
Current Bladder Dysfunction Reports / Ausgabe 2/2016
Print ISSN: 1931-7212
Elektronische ISSN: 1931-7220
DOI
https://doi.org/10.1007/s11884-016-0354-7

Weitere Artikel der Ausgabe 2/2016

Current Bladder Dysfunction Reports 2/2016 Zur Ausgabe

Voiding Dysfunction Evaluation (C Gomez, Section Editor)

Evaluation and Management of Mid-Urethral Sling Complications

Pelvic Pain (R Moldwin and S Bahlani, Section Editors)

Neuromodulation for Pelvic Pain and Sexual Dysfunction

BPH-Related Voiding Dysfunction (R Lee, Section Editor)

Aquablation™: Early Clinical Results

Pelvic Pain (R Moldwin and S Bahlani, Section Editors)

The Role of Urinary Diversion for Bladder Pain

Cancer-Associated Voiding Dysfunction (A Peterson, Section Editor)

Management of End-Stage Radiation Cystitis in the Cancer Survivor

Alphablocker schützt vor Miktionsproblemen nach der Biopsie

16.05.2024 alpha-1-Rezeptorantagonisten Nachrichten

Nach einer Prostatabiopsie treten häufig Probleme beim Wasserlassen auf. Ob sich das durch den periinterventionellen Einsatz von Alphablockern verhindern lässt, haben australische Mediziner im Zuge einer Metaanalyse untersucht.

S3-Leitlinie zur unkomplizierten Zystitis: Auf Antibiotika verzichten?

15.05.2024 Harnwegsinfektionen Nachrichten

Welche Antibiotika darf man bei unkomplizierter Zystitis verwenden und wovon sollte man die Finger lassen? Welche pflanzlichen Präparate können helfen? Was taugt der zugelassene Impfstoff? Antworten vom Koordinator der frisch überarbeiteten S3-Leitlinie, Prof. Florian Wagenlehner.

Viel pflanzliche Nahrung, seltener Prostata-Ca.-Progression

12.05.2024 Prostatakarzinom Nachrichten

Ein hoher Anteil pflanzlicher Nahrung trägt möglicherweise dazu bei, das Progressionsrisiko von Männern mit Prostatakarzinomen zu senken. In einer US-Studie war das Risiko bei ausgeprägter pflanzlicher Ernährung in etwa halbiert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.