Manifestation, latency and management of late urological complications after curative radiotherapy for XXXX .

@entity1 @entity1901 @entity1494 @entity39 @entity5 @entity2622 @entity3041 @entity3832 @entity2335 @entity4570
BACKGROUND: Radiotherapy alone or in combination with radical hysterectomy remains a potentially curative treatment for @entity2622 . Late urological complications after curative radiotreatment are rare but often present difficult problems of management due to the progressive nature of radiogenic tissue damage. We reviewed all cases of radiogenic urologic complications after radiotherapy for @entity2622 treated at our institution over the past 10 years. @entity1 AND METHODS: In a retrospective analysis, out of all female @entity1 treated for @entity3041 (n = 543), 93 @entity1 with @entity3041 occurring after curative treatment for gynecological @entity5 were identified. The most frequent cause was progressive disease (n = 55); 30 @entity1 without recurrence had severe radiogenic urological complications (study population). RESULTS: Out of 30 @entity1 with a mean age of 44.9 years at the time of treatment for @entity5 , 6 had undergone primary radiotherapy and 24 had received adjuvant radiotreatment after radical hysterectomy. The observed late urological complications were: distal ureteral stenoses (bilateral in 4 cases, unilateral in 15 cases), distal @entity39 (n = 1), bilateral ureteral reflux (n = 3), vesico-vaginal fistulae (n = 5), @entity4570 (n = 1), severe @entity1494 shrinkage (n = 6) and @entity3832 (n = 2). Marked signs of radiogenic @entity2335 were observed in almost all @entity1 . The mean latency time between radiotherapy and manifestation of severe radiogenic urological sequelae was 19.4 years (range 0.5-41.5). Primary treatment of urological complications consisted in temporary urinary diversion by percutaneous nephrostomies or insertion of internal ureteral stents. Permanent treatment for radiogenic @entity1901 in all @entity1 with sufficient general health consisted of surgical or endourological urinary diversion or reconstruction. However, the majority of @entity1 were managed by permanent endourological measures. Lower tract fistulae were treated by distal ureteral occlusion and diversion. CONCLUSIONS: Although severe late urological sequelae of curative radiotherapy for @entity2622 are rare they represent major complications, result in considerable distress for the @entity1 , and often present difficult therapeutic problems for the urologist. As these urological complications can have extremely long latency times, focussed follow-up for early detection may be advisable.
