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Urological complications after radical hysterectomy with postoperative radiotherapy and radiotherapy alone for cervical cancer.

Abstract Radiotherapy is a reliable method to cure cervical cancer patients, but it could cause serious urological complications after the treatment due to the anatomical location of the cervix. The main purpose of this retrospective analysis is to study the incidence, latency, and therapeutic efficacy of urological complications caused by radical hysterectomy with postoperative radiotherapy or radiotherapy alone in patients with cervical cancer.A retrospective analysis was conducted on patients with cervical cancer who received radical hysterectomy with postoperative radiotherapy or radiotherapy alone at the First Hospital of Jilin University between January 2010 and May 2016. The urological complications were confirmed by clinical manifestation, ultrasound, computed tomography (CT), nuclear scintigraphy, and assessment of renal function. All the patients with urological complications received conventional treatment, including conservative, electrosurgery, ureteral stents, nephrectomy, and neoplasty. The onset time of radiation injury symptoms was confirmed according to the medical history and follow-up. The surveillance for the therapeutic effects for these complications was accomplished by cystoscopy, imaging, and laboratory assessment.The overall rate of urological complications after treatment was 3.26%, comprising 2.12% ureteral obstruction, 0.98% radiocystitis, and 0.16% vesicovaginal fistula. The incidence of ureteral obstruction in patients treated with radical hysterectomy with postoperative radiotherapy and radiotherapy alone was not statistically significant (2.18% vs 1.59%, Pā€Š>ā€Š.05). The median onset time of radiocystitis and ureteral obstruction was 10 months (0-75 months) and 12 months (2-66.3 months), respectively. The onset time of vesicovaginal fistula was 3.5 months. After the appropriate treatment, the majority of the complications were under control.The incidence of urological complications is acceptable. There was no statistical difference in the risk between patients treated with radical hysterectomy with postoperative radiotherapy and radiotherapy alone. The latency period between radiotherapy and the manifestation of urological complications may be relatively long. So it is crucial to underline long-term follow-up after radiotherapy. The majority of urological complications were alleviated after symptomatic treatment and the patients with cervical cancer achieved long-term remissions or cures.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29595646
OWN - NLM
STAT- MEDLINE
DCOM- 20180405
LR  - 20180405
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 13
DP  - 2018 Mar
TI  - Urological complications after radical hysterectomy with postoperative
      radiotherapy and radiotherapy alone for cervical cancer.
PG  - e0173
LID - 10.1097/MD.0000000000010173 [doi]
AB  - Radiotherapy is a reliable method to cure cervical cancer patients, but it could 
      cause serious urological complications after the treatment due to the anatomical 
      location of the cervix. The main purpose of this retrospective analysis is to
      study the incidence, latency, and therapeutic efficacy of urological
      complications caused by radical hysterectomy with postoperative radiotherapy or
      radiotherapy alone in patients with cervical cancer.A retrospective analysis was 
      conducted on patients with cervical cancer who received radical hysterectomy with
      postoperative radiotherapy or radiotherapy alone at the First Hospital of Jilin
      University between January 2010 and May 2016. The urological complications were
      confirmed by clinical manifestation, ultrasound, computed tomography (CT),
      nuclear scintigraphy, and assessment of renal function. All the patients with
      urological complications received conventional treatment, including conservative,
      electrosurgery, ureteral stents, nephrectomy, and neoplasty. The onset time of
      radiation injury symptoms was confirmed according to the medical history and
      follow-up. The surveillance for the therapeutic effects for these complications
      was accomplished by cystoscopy, imaging, and laboratory assessment.The overall
      rate of urological complications after treatment was 3.26%, comprising 2.12%
      ureteral obstruction, 0.98% radiocystitis, and 0.16% vesicovaginal fistula. The
      incidence of ureteral obstruction in patients treated with radical hysterectomy
      with postoperative radiotherapy and radiotherapy alone was not statistically
      significant (2.18% vs 1.59%, P > .05). The median onset time of radiocystitis and
      ureteral obstruction was 10 months (0-75 months) and 12 months (2-66.3 months),
      respectively. The onset time of vesicovaginal fistula was 3.5 months. After the
      appropriate treatment, the majority of the complications were under control.The
      incidence of urological complications is acceptable. There was no statistical
      difference in the risk between patients treated with radical hysterectomy with
      postoperative radiotherapy and radiotherapy alone. The latency period between
      radiotherapy and the manifestation of urological complications may be relatively 
      long. So it is crucial to underline long-term follow-up after radiotherapy. The
      majority of urological complications were alleviated after symptomatic treatment 
      and the patients with cervical cancer achieved long-term remissions or cures.
FAU - Li, Faping
AU  - Li F
AD  - Department of Urology, The First Hospital of Jilin University, Changchun, P.R.
      China.
FAU - Guo, Hui
AU  - Guo H
FAU - Qiu, Heping
AU  - Qiu H
FAU - Liu, Shukun
AU  - Liu S
FAU - Wang, Kaixuan
AU  - Wang K
FAU - Yang, Chao
AU  - Yang C
FAU - Tang, Chao
AU  - Tang C
FAU - Zheng, Qi
AU  - Zheng Q
FAU - Hou, Yuchuan
AU  - Hou Y
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Humans
MH  - Hysterectomy/*adverse effects
MH  - Incidence
MH  - Middle Aged
MH  - Postoperative Complications/*epidemiology
MH  - Radiation Injuries/*epidemiology
MH  - Radiotherapy, Adjuvant/adverse effects
MH  - Retrospective Studies
MH  - Urologic Diseases/*epidemiology
MH  - Uterine Cervical Neoplasms/*radiotherapy/*surgery
MH  - Young Adult
EDAT- 2018/03/30 06:00
MHDA- 2018/04/06 06:00
CRDT- 2018/03/30 06:00
PHST- 2018/03/30 06:00 [entrez]
PHST- 2018/03/30 06:00 [pubmed]
PHST- 2018/04/06 06:00 [medline]
AID - 10.1097/MD.0000000000010173 [doi]
AID - 00005792-201803300-00019 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Mar;97(13):e0173. doi: 10.1097/MD.0000000000010173.