The effects of simple and radical hysterectomy and radiotherapy on lower urinary tract symptoms and urodynamics

Purpose: To evaluate effects of simple/radical hysterectomy, radiotherapy, and their combination on lower urinary tract symptoms (LUTS) and urodynamics. Materials and methods: Four groups were formed as simple hysterectomy; Group 1 (n = 20), Type-II hysterectomy; Group 2 (n = 11), Type-II hysterectomy + radiotherapy; Group 3 (n = 16), radiotherapy; Group 4 (n = 20). LUTS, bladder diary, pad test, Q-tip test, stress-test, urodynamics, bladder-wall-thickness measurement, King's Health Questionnaire (KHQ) performed prior and at six and 18 months after treatment. Results: Pre-treatment prevalence of LUTS was higher in Group 1 and decreased at six and 18 months. LUTS increased in Groups 2, 3, and 4 at six months; some of the symptoms decreased to pre-treatment levels at 18 months. Quality of life improved in Group 1 and worsened in the others. Maximum bladder capacity increased in Group 1 and decreased in Groups 2 and 3. Bladder-wall-thickness, maximum detrusor pressures increased, urine sensation decreased in Groups 2 and 4. Maximum vesical pressure increased and compliance decreased in Groups 2 and 3. Conclusion: LUTS may decrease after simple hysterectomy. Radical hysterectomy and radiotherapy result in voiding dysfunction; however some of the symptoms may decrease to pre-treatment levels during follow-up.

Cervical cancer; Endometrium cancer; Hysterectomy; Lower urinary tract dysfunction; Radiotherapy; Urinary inconti-nence

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