| Summary: | Bladder symptoms 5-11 years after radiotherapy for cervical carcinoma were investigated by postal questionnaire in 66 women. 25% complained of severe bladder symptoms and 30% of moderate symptoms. The most common symptoms were urgency and urge incontinence. Symptoms in a group of postmenopausal women were significantly less and were not altered by taking hormone replacement or placebo for 16 years. Bladder function measured urodynamically in women with cervical carcinoma prior to treatment was normal, suggesting that cervical carcinoma does not alter bladder function. Following radiotherapy voiding was unaltered. Bladder capacity is reduced but only by 80ml. Detrusor pressure rises slowly for at least 5 years after radiotherapy, but only to a mean of 13 cmH20. unstable detrusor contractions were found in 30% of women 5 or more years after radiotherapy and appear to be the cause of symptoms in these women, not a fibrosed, contracted bladder as thought. Major bladder complications following radiotherapy had an incidence of 1.7% with fistulae in 1.4%. After radical hysterectomy 25% complained of stress incontinence and 75% had voiding problems. Maximum flow rate was reduced and residual volume increased. The prospective study found a reduction in functional urethral length and maximum urethral closure pressure at six months despite the posterior lcm of the cardinal ligament being preserved. The combination of radical postoperative radiotherapy caused detrusor pressure was increased detrusor instability. hysterectomy voiding with a to high and adjuvant be unchanged, incidence of Radiotherapy therefore may be a cause of detrusor instability. As bladder dysfunction is common after any treatment for cervical carcinoma patients should be followed up with regard to this and offered urodynamic investigation.
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