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Minerva Medica 2021 February;112(1):96-110

DOI: 10.23736/S0026-4806.20.06770-1


lingua: Inglese

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

George A. VILOS 1 , Enrique REYES-MUÑOZ 2, Gaetano RIEMMA 3, 4, Ilker KAHRAMANOGLU 5, Li-Te LIN 6, Benito CHIOFALO 7, Patricia LORDELO 8, Luigi DELLA CORTE 9, Amerigo VITAGLIANO 10, Gaetano VALENTI 11

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, Isidro Espinosa de los Reyes National Institute of Perinatology, Mexico City, Mexico; 3 Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli University of Campania, Naples, Italy; 4 Division of Gynecologic Oncology, Department of Women’s and Children’s Health, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy; 5 Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine, University of Instanbul, Istanbul, Turkey; 6 Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; 7 Unit of Gynecologic Oncology, Department of Experimental Clinical Oncology, Regina Elena National Cancer Institute, Rome, Italy; 8 Centro de Atenção ao Piso Pélvico (CAAP), Division of Physiotherapy, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil; 9 Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University, Naples, Italy; 10 Department of Women and Children’s Health, University of Padua, Padua, Italy; 11 Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy

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 urogynecological evaluation should be considered as an important part of oncological treatment and follow-up.

KEY WORDS: Lower urinary tract symptoms; Hysterectomy; Drug therapy; Radiotherapy

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