Long-term lower urinary tract dysfunction in gynecologic cancer survivors.

OBJECTIVE: To determine the prevalence of lower urinary tract dysfunction (LUTD) in gynecologic cancer survivors after radical hysterectomy (RH) as compared to total abdominal hysterectomy (TAH). The impact on quality of life (QOL) was also evaluated.
MATERIALS AND METHODS: From January to April 2010, 108 gynecologic cancer survivors (52 cervical, 28 ovarian and 28 endometrial cancer patients) who underwent primary surgery at King Chulalongkorn Memorial Hospital completed the Urogenital Distress Inventory and Incontinence Impact Questionnaire (UDI and IIQ). The UDI has 3 subscales for 19 items of symptoms associated with LUTD. The IIQ is a QOL questionnaire which has 4 subscales for 30 items refering to degree of urinary incontinence affecting various activities and emotions. A higher score indicates a greater impairment of QOL.
RESULTS: The RH group was younger (52.3 ± 8.0 years) than TAH group (56.2 ± 9.1 years), with a lower nulliparous rate (13.2% and 55.4%) but more sexual activity (56.6% and 21.4%). Median time from primary surgery was the same in both groups (5 years, range 3-20). Seventy gynecologic cancer survivors (64.8%) had LUTD, without significant variation between the two groups (68.6% and 61.4%, respectively). However, the RH group had significantly more stress urinary incontinence (45.1% as compared to 21% for the TAH group) and voiding dysfunction (31.4% and 1.8%). The total scores and scores from most UDI subscales except irritative symptoms were significantly higher in the RH group. In contrast, there were no differences in total and all IIQ subscale scores.
CONCLUSION: Stress urinary incontinence and voiding dysfunction were prevalent in gynecologic cancer survivors after RH. However, there was no impact on QOL when compared to survivors undergoing TAH.