Abstract
A 40-year-old woman was evaluated for urinary incontinence, loss of bladder sensation and residual urine 12 months after radical abdominal hysterectomy and external pelvic radiation therapy for stage IIb cervical cancer. The patient had no history of abnormal lower urinary tract function before treatment. The urodynamic follow-up study at 12 months showed 80 ml of residual urine, low bladder compliance (detrusor pressure of 77 cmH2O at 200 ml filling) and an incompetent urethral closure mechanism. Cystoscopy showed a pale bladder mucosa with telangiectasia. Two years later the urodynamic findings were almost unchanged, and pudendal nerve terminal motor latency measured according to Snooks and Swash showed prolonged motor latency to the external urethral sphincter. Thus, this patient had combined stress overflow incontinence with pudendal neuropathy and fibrosis of the bladder wall.
Similar content being viewed by others
References
Sasaki H, Yoshida T, Noda K, Yachiku S, Minami K, Kaneko S. Urethral pressure profiles following radical hysterectomy. Obstet Gynecol 1982;59:101–104
Ralph G, Tamussino K, Lichtenegger W. Urologic complications after abdominal hysterectomy for cervical cancer. Clin Obstet Gynecol 1988;2:943–952
Scotti RJ, Bergmann A, Bhatia NN, Ostergard DR. Urodynamic changes in urethrovesical function after radical hysterectomy. Obstet Gynecol 1986;68:111–119
Farquharson DIM, Shingleton HM, Sanford SP, Soony S-J, Varner RE, Hester S. The short-term effect of pelvic irradiation for gynecologic malignancies on bladder function. Obstet Gynecol 1987;70:81–84
Abrams P, Blaivas JG, Stanton SL, Andersen JT. The standardization of terminology of lower urinary tract function recommended by the International Continence Society. Int Urogynecol J 1990;1:45–458
Snooks SJ, Swash M. Perineal nerve and transcutaneous spinal stimulation: new methods for investigation of the urethral striated sphincter musculature. Br J Urol 1984;56:406–409
Smith PH, Ballantyne B. The neuroanatomic basis for denervation of the urinary bladder following major pelvic surgery Br J Surg 1968;55:929–932
Antonakopoulos GN, Hicks RM, Bery RJ. The subcellular basis of damage to the human urinary bladder induced by irradiation. J Pathol 1984;143:103–116
Magrina JF. Urologic complications of radiation therapy for gynecologic malignancies. Int Urogynecol J 1993;4:111–115
Minini GF, Simeone C, Zambolin T, Roggia A, Cosciani-Cunico S, Gastaldi A. Long-term functional sequelae of the urinary tract following surgical treatment of carcinoma of the cervix with and without extended radiation therapy. Int Urogynecol J 1992;3:8–11
Snooks SJ, Swash M. Abnormalities of the innervation of the urethral sphincter musculature in incontinence. Br J Urol 1984;56:401–405
Eberhard J. Standardisierte Urethradruckmessung mit Normwerten zur Stressinkontinenzdiagnostik. Geburtsh Frauenheilk 1986;46:145–150
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Zivkovic, F., Ralph, G., Tamussino, K. et al. Stress-overflow urinary incontinence after radical hysterectomy and radiation therapy for cervical cancer. Int Urogynecol J 5, 305–308 (1994). https://doi.org/10.1007/BF00376248
Issue Date:
DOI: https://doi.org/10.1007/BF00376248