Katepratoom Chanita, Manchana Tarinee, Amornwichet Napapat
Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
Int Urogynecol J. 2014 Jan;25(1):91-6. doi: 10.1007/s00192-013-2151-6. Epub 2013 Jul 2.
Lower urinary tract dysfunction (LUTD) is a common morbidity. Due to the different pathophysiology of LUT injury, we compared LUTD between patients who received concurrent chemoradiation (CCRT) and radical hysterectomy (RH).
Seventy cervical cancer survivors were evaluated with multichannel urodynamic studies. The CCRT group received a total dose of 54 Gy pelvic radiation with 2-3 high-dose-rate brachytherapy, concurrent with platinum-based chemotherapy. The RH group underwent type III RH without pre- or postoperative radiation.
Overall, LUTD was insignificantly different between CCRT and RH (60 % and 68.6 %). Voiding dysfunction was significantly higher in RH, particularly high postvoid residual urine and void with abdominal straining. However, storage dysfunction, particularly low bladder compliance and increased bladder sensation, were significantly more prevalent in CCRT; urinary incontinence was not significantly different between groups.
LUTD was prevalent in cervical cancer survivors. Different profiles of dysfunction were demonstrated. Voiding dysfunction was higher followng RH, but storage dysfunction was higher following CCRT.
下尿路功能障碍（LUTD）是一种常见疾病。由于下尿路损伤的病理生理学不同，我们比较了接受同步放化疗（CCRT）和根治性子宫切除术（RH）的患者的下尿路功能障碍情况。
对70名宫颈癌幸存者进行了多通道尿动力学研究。CCRT组接受了总量为54 Gy的盆腔放疗，并进行了2 - 3次高剂量率近距离放疗，同时接受铂类化疗。RH组接受了III型RH，术前或术后均未进行放疗。
总体而言，CCRT组和RH组的LUTD差异不显著（分别为60%和68.6%）。RH组排尿功能障碍明显更高，尤其是排尿后残余尿量高以及需腹部用力排尿。然而，储尿功能障碍，特别是膀胱顺应性低和膀胱感觉增强，在CCRT组中更为普遍；两组间尿失禁差异不显著。
LUTD在宫颈癌幸存者中普遍存在。显示出不同的功能障碍特征。RH后排尿功能障碍较高，但CCRT后储尿功能障碍较高。
