Urinary incontinence and other pelvic floor disorders after radiation therapy in endometrial cancer survivors

OBJECTIVE

To investigate radiation therapy as a risk factor for urinary or fecal incontinence, pelvic organ prolapse, and sexual dysfunction in endometrial cancer survivors.

STUDY DESIGN

We performed a retrospective cohort study of endometrial cancer survivors. Data were collected using a mailed survey and the medical record. Validated questionnaires were used to generate rates of urinary incontinence and other pelvic floor disorders. The incidence rates of pelvic floor disorders were compared across groups with different exposures to radiation.

RESULTS

Of the 149 endometrial cancer survivors, 41% received radiation therapy. Fifty-one percent of women reported urine leakage. The rates of urinary incontinence in women exposed and not exposed to vaginal brachytherapy (VBT) or whole-pelvis radiation were 48% and 58%, respectively (p=0.47). The incidence of fecal incontinence did not differ between groups, but the score for overall sexual function was significantly higher in women who did not undergo radiation therapy. On multivariable analysis, significant risk factors for urinary incontinence were age (AOR 1.06 95% CI 1.02, 1.10) and BMI (AOR 1.07 95% CI 1.02, 1.11), but treatment with radiation was not significantly associated with urinary incontinence, or fecal incontinence (p>0.05). Age, BMI, and radiation exposure were independent predictors of decreased sexual function score (p<0.01).

CONCLUSION

Local or regional radiation is not associated with urinary or fecal incontinence, but may contribute to sexual dysfunction in endometrial cancer survivors.