Urinary tract complications apparently resulting from
radiation therapy for
carcinoma of the cervix can occur as long as 30 years after cessation of such treatment. Patients generally present with
urinary incontinence and often are treated by standard operative methods that usually are unsuccessful. Incontinence is related to bladder
fibrosis, urethral nonfunction and
vesicovaginal fistuLa formation, and may be accompanied by bilateral
ureteral obstruction. Of 11 patients with late complications of
radiotherapy 4 had upper tract deterioration, 4 had
vesicovaginal fistulas, 5 had an incompetent urethra aNd 9 had a fibrotic, noncompliant areflexive bladder. Treatment was aimed at providing adequate low pressure storage capacity and consisted of augmentation cystoplasty in 5 patients, repair of the
fistula in 4 and correction of urethral dysfunction in 5. Women who complain of incontinence and/or irritable bladder symptoms with a history of
radiotherapy for cervical
carcinoma should be evaluated for
fistuLa formation, urethral incompetence, and detrusor areflexia and
fibrosis before treatment is done.