Evaluation of urologic morbidity after radiotherapy for cervical carcinoma by urodynamic examinations and patient voiding schemes: a prospective study.

Abstract

To assess urologic morbidity in a 5-year period by urodynamic examinations and patient voiding schemes after radiotherapy and brachytherapy for cervical carcinoma. Thirty-six consecutive patients designated to receive radiotherapy with curative intent entered the study on urodynamic changes after radiotherapy for cervical carcinoma. Patients in the study had urodynamic examinations performed on admission and 3, 9, 18, 24, 30, 36, 48, and 60 months after radiotherapy. In addition, the patients were instructed to record 24-h voiding schemes before each consultation. Each voiding scheme contained information about exact time of voiding and amount voided, as well as time of involuntary voiding, if present. No changes were observed in the urodynamic parameters: volume of residual urine, maximum bladder capacity, maximum flow rate, or volume of first bladder sensation. Detrusor instability and frequent small voiding did develop in 15%-20% of patients during follow-up. Incontinence after therapy was, however, a rare observation. In a prospective design combining urodynamic examinations and patient voiding schemes, and with modern application techniques, presence of minor urologic morbidity was found to be much more rare than previously reported. Nevertheless, detrusor instability and frequent small voiding did develop in 15%-20% of patients during follow-up. Future studies should be concerned about possible bias from urologic morbidity unrelated to therapy.