Radiotherapy improves stress urinary incontinence but impairs pelvic floor function in endometrial cancer patients: a prospective cohort study

Purpose

Investigating the impact of radiotherapy on urinary incontinence and pelvic floor dysfunction in endometrial cancer patients.

Method

A comparative study was conducted between endometrial cancer patients who underwent radiotherapy and those who did not receive adjuvant therapy. Patients were assessed during their first follow-up visit at third month post-radiotherapy or post-surgery. Demographic data and physical examinations were conducted, along with the administration of validated questionnaires. Turkish validated Incontinence Severity Index (ISI), Incontinence Impact Questionairre-7 (IIQ-7) and 20 ıtem Pelvic Floor Dysfunction Index (PFDI-20) were applied to the all patients.

Results

The study comprised 37 patients in the non-radiotherapy group and 41 patients in the radiotherapy group. Comparable demographics were observed between the two groups. Vaginal length was notably longer in the non-radiotherapy group, and the Q-tip test angle was significantly greater in this group. A higher incidence of stress urinary incontinence and higher scores on the Incontinence Severity Index were noted in the non-radiotherapy group. Conversely, the radiotherapy group exhibited significantly higher scores on the Pelvic Floor Dysfunction Index components and total score. Urogenital Distress Inventory scores were similar between the groups.

Conclusion

Radiotherapy showed mixed effects on pelvic floor function in endometrial cancer patients. While it potentially improved stress urinary incontinence, it was associated with unfavorable outcomes in overall pelvic floor dysfunction.