Treatments for invasive carcinoma of the cervix: what are their impacts on the pelvic floor functions?

• Published in: International Brazilian Journal of Urology Vol. 39; no. 1; pp. 46 - 54
• Main Authors: Noronha, Alessandra Ferreira de, Mello de Figueiredo, Elyonara, Rossi de Figueiredo Franco, Telma Maria, Cândido, Eduardo Batista, Silva-Filho, Agnaldo L
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Urologia 01.01.2013
• Subjects: Adult; Carcinoma - therapy; Chemoradiotherapy; Chemoradiotherapy - adverse effects; Epidemiologic Methods; Female; Humans; Hysterectomy; Hysterectomy - adverse effects; Middle Aged; Muscle Contraction; Pelvic Floor; Pelvic Floor - physiopathology; Pelvic Floor - radiation effects; Radiation; Radiotherapy - adverse effects; Sexual Dysfunction, Physiological - physiopathology; Treatment Outcome; Urinary Incontinence - physiopathology; Uterine Cervical Neoplasms; Uterine Cervical Neoplasms - therapy; Vagina - physiopathology
• ISSN: 1677-5538; 1677-6119; 1677-6119; 1677-5538
• DOI: 10.1590/S1677-5538.IBJU.2013.01.07

Describe the impact of surgery, radiotherapy and chemoradiation in the pelvic floor functions in cervical cancer patients. A prospective study with women submitted to radical hysterectomy (RH) (n = 20), exclusive radiotherapy (RT) (n = 20) or chemoradiation (CT/RT) (n = 20) for invasive cervical cancer. Urinary, intestinal and sexual function, as well as vaginal length and pelvic floor muscle contraction were evaluated. Comparisons between groups were performed by Kruskal-Wallis and Chi-square tests (p < 0.05). The groups were similar in stress urinary incontinence incidence (p = 0.56), urinary urgency (p = 0.44), urge incontinence (p = 0.54), nocturia (p = 0.53), incomplete bowel emptying (p = 0.76), bowel urgency (p = 0.12) and soilage (p = 0.43). The CT/RT group presented a higher urinary frequency (p < 0.001) and diarrhea (p = 0.025). Patients in the RH group were more sexually active (p = 0.01) and experienced less dyspareunia (p = 0.021). Vaginal length was shorter in RT group (5.5 ± 1.9 cm) and CT/RT(5.3 ± 1.5 cm) than in the RH group (7.4 ± 1.1 cm) (p < 0.001). Pelvic floor muscle contraction was similar (p = 0.302). RT and CT/RT treatment for cervical carcinoma are more associated to sexual and intestinal dysfunctions.