BACKGROUND: In contrast to proctitis, vaginitis and acute radiation cystitis are late complications of pelvic radiation therapy, rare, more severe and irreversible. CASE DESCRIPTION: A 66-year-old patient presented with progressive renal failure ten years after radiotherapy for carcinoma of the cervix. Ultrasound investigation revealed a bilateral hydroutereronefrosis (grade 4), with narrowing of the ureterovesical junctions and a diffuse thickening of the urinary bladder wall. Biopsy of the bladder wall showed extended necrosis. The diagnosis was a necrotic bladder with bilateral ureteral stenosis without local symptoms. Lifelong renal urinary drainage was indicated. CONCLUSION: Late obstructive urological complications, such as bladder necrosis and urethral obstruction, are rare following radiotherapy for cervical carcinoma. Ultrasound follow-up can contribute to the early detection of these complications and intervention can prevent further loss of renal function; however, this would not be cost-effective because of the low incidence rate and because these complications appear in the long term.
BACKGROUND: In contrast to proctitis, vaginitis and acute radiation cystitis are late complications of pelvic radiation therapy, rare, more severe and irreversible. CASE DESCRIPTION: A 66-year-old patient presented with progressive renal failure ten years after radiotherapy for carcinoma of the cervix. Ultrasound investigation revealed a bilateral hydroutereronefrosis (grade 4), with narrowing of the ureterovesical junctions and a diffuse thickening of the urinary bladder wall. Biopsy of the bladder wall showed extended necrosis. The diagnosis was a necrotic bladder with bilateral ureteral stenosis without local symptoms. Lifelong renal urinary drainage was indicated. CONCLUSION: Late obstructive urological complications, such as bladder necrosis and urethral obstruction, are rare following radiotherapy for cervical carcinoma. Ultrasound follow-up can contribute to the early detection of these complications and intervention can prevent further loss of renal function; however, this would not be cost-effective because of the low incidence rate and because these complications appear in the long term.