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Minerva Medica 2020 Jul 22

DOI: 10.23736/S0026-4806.20.06770-1

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Gynecological cancers and urinary dysfunction: a comparison between endometrial cancer and other gynecological malignancies

George A. VILOS 1 , Enrique REYES-MUNOZ 2, Gaetano RIEMMA 3, Ilker KAHRAMANOGLU 4, Li-Te LIN 5, Benito CHIOFALO 6, Patricia LORDELO 7, Luigi DELLA CORTE 8, Amerigo VITAGLIANO 9, Gaetano VALENTI 10

1 Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; 2 Department of Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico; 3 Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy; 4 Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey; 5 Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; 6 Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, "Regina Elena" National Cancer Institute, Rome, Italy; 7 Centro de Atenção ao Piso Pélvico (CAAP), Divisão de Fisioterapeutas e Pós-Graduação, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Ba, Brasil; 8 Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy; 9 Department of Women and Children's Health, University of Padua, Padua, Italy; 10 Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy


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The purpose of this paper is to provide a narrative overview of the available literature about voiding dysfunction in women with gynecological cancer before and after surgical, chemo- and radiotherapy treatments. Radical surgery, radiotherapy, and chemotherapy may cause lower urinary tract dysfunction such as stress and urge urinary incontinence, and voiding difficulties. However, nerve sparing radical hysterectomy may be a valid surgical approach in order to reduce bladder innervation impairment and maintain normal urinary function. Also, newer radiotherapy techniques significantly reduce the number of adverse effects, including bladder dysfunction. Pelvic floor muscle physiotherapy and training with biofeedback and urethral bulking agents represent some additional therapies that can be used in oncologically treated patients with urinary symptoms in order to improve a significant aspect of their quality of life. Considering the important impact on the patients’ quality of life, a full urogynaecological evaluation should be considered as an important part of oncological treatment and follow-up.


KEY WORDS: Gynecological cancer; Lower urinary tract dysfunction; Radical hysterectomy; Voiding dysfunction; Chemotherapy; Radiotherapy

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