Introduction/Background

Cervical cancer is oftentimes plagued by several urological complications during or post treatment. Early disease is mainly managed with radical hysterectomy, while more advanced disease is usually treated by chemoradiation. Although urological complications of cervical cancer treatment have declined during the past decades, owing to improvements in various therapeutic modalities, the incidence of those complications has not yet precisely defined.

Methodology

Cervical cancer patients between 2009 and 2020 were retrospectively reviewed from the cancer database of our tertiary institution. 

Results

420 women were diagnosed with cervical cancer of any stage in our cancer hospital. 122 (29 %) of those women had early stage disease and thus were managed  with radical hysterectomy (RH); the remaining 294 (71%) underwent chemoradiation, chemotherapy, or palliative therapy. 5 out of 122 RH patients (4%) experienced urological adverse events, and namely intraoperative ureteric injury, intraoperative and urinary bladder injury and postoperative ureteral necrosis . One patient (0.8%) was managed with primary end to end ureteral anastomosis, another (0.8%) with intraoperative bladder repair, one patient (0.8%) had Boari flap formation, and two (1.6%) underwent ureteral reimplantation (reoperation on the 10th and 14th postoperative day respectively). In 24 RH patients (19.6% % ) prophylactic cystoscopic ureteral stenting had taken place before the operation. As for the non RH group (294 patients) 10 (3.4%) had prophylactic cystoscopic stenting, while 3 patients (1 %) underwent nephrostomy placement. 

Conclusion

Cervical cancer management  –either surgical or conservative -is often accompanied by various urological complications. Prophylactic ureteral stenting, meticulous surgical technique, prompt diagnosis and management of urological adverse events are of paramount importance when dealing with cervical cancer. 

Disclosures
The authors declare no conflicts of interest.

UROLOGICAL COMPLICATIONS OF CERVICAL CANCER TREATMENT : Α RETROSPECTIVE ANALYSIS OF 420 PATIENTS