Résumé
La radiothérapie pelvienne peut déterminer diverses complications neurologiques. La myélite radiothérapique est la plus fréquente, mais des plexopathies sacrées postradiques peuvent aussi survenir. Les troubles mictionnels sont caractérisés par un syndrome clinique d’hyperactivité vésicale avec pollakiurie, incontinence sur urgence et impériosité, secondaire à une hyperactivité du détrusor ou à un défaut de compliance. En cas d’atteinte neurogène purement périphérique, rétention urinaire et fuite sur défaillance sphinctérienne peuvent s’observer.
Abstract
Pelvic irradiation can lead to various neurologic syndromes. Radiation myelopathy is the most common lesion, but acute and chronic lumbosacral plexopathy can occur several months or years after pelvic irradiation. Micturitional disturbances are characterized by overactive bladder syndrome with frequency, urgency, and urge incontinence. These symptoms are secondary to detrusor overactivity or compliance alteration during the filling phase. In case of neurogenic peripheral lesions, urinary retention and stress incontinence following lack of urethral sphincter pressures are observed.
This is a preview of subscription content, log in via an institution to check access.
Références
Lin HH, Sheu BC, Lo MC, Huang SC (1998) Abnormal urodynamic findings after radical hysterectomy or pelvic irradiation for cervical cancer. Int J Gynaecol Obstet 63: 169–174
Sakakibara R, Hattori T, Tojo M, et al (1993) Micturitional disturbance in radiation myelopathy. J Spinal Disord 6: 402–405
Bandy LC, Clarke-Pearson DL, Soper JT, et al (1987) Long-term effects on bladder function following radical hysterectomy with and without postoperative radiation. Gynecol Oncol 26: 160–168
D’Ancona CA, Cavaller AR, Ferreira U, et al (2005) Continent urinary diversion in patients with pelvic irradiation: an alternative utilizing transverse colon reservoir. Int Urol Nephrol 37(3): 499–500
Frykholm GJ, Sintorn K, Montelius A, et al (1996) Acute lumbosacral plexopathy during and after preoperative radiotherapy of rectal adenocarcinoma. Radiother Oncol 38(2): 121–130
Georgiou A, Grigsby PW, Perez CA (1993) Radiation induced lumbosacral plexopathy in gynecologic tumors: clinical findings and dosimetric analysis. Int J Radiat Oncol Biol Phys 26(3): 479–482
Pettigrew LC, Glass JP, Maor M, Zornoza J (1984) Diagnosis and treatment of lumbosacral plexopathies in patients with cancer. Arch Neurol 41(12): 1282–1285
Su WR, Lee JS, Chen HH, et al (2009) Neurophysiological and histopathological evaluation of low-dose radiation on the cauda equina and postlaminotomy fibrosis: an experimental study in the rat. Spine (Phila Pa 1976) 34(5): 463–469
Shimazaki H, Nakano I (2008) Radiation myelopathy and plexopathy. Brain Nerve 60(2): 115–121
Dahele M, Davey P, Reingold S, Shun Wong C (2006) Radiationinduced lumbo-sacral plexopathy (RILSP): an important enigma. Clin Oncol (R Coll Radiol) 18(5): 427–428
Jaeckle KA (2004) Neurological manifestations of neoplastic and radiation-induced plexopathies. Semin Neurol 24(4): 385–393
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Jousse, M., Verollet, D., Le Breton, F. et al. Les complications neuropérinéales de la radiothérapie pelvienne. Pelv Perineol 5, 113–115 (2010). https://doi.org/10.1007/s11608-010-0299-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11608-010-0299-9