Long-term bladder, colorectal, and sexual functions after radical radiotherapy for urinary bladder cancer

To describe bladder, colorectal, and sexual dysfunctions among long time survivors after radical radiotherapy for urinary bladder cancer, and compare the results with a healthy control group.

We identified 261 patients who had received radical radiotherapy for bladder cancer in the period 1994-2001. Patients were treated with a CT-based three-field technique with 60 Gy in 2 Gy fractions, 5 fractions/week. Sixty-two patients were alive and candidates for the study. For comparison, 185 controls were selected from the Danish National Register. Information was collected in an interview based on the LENT SOMA tables and questions concerning changes in daily life following radiotherapy.

Fifty-three patients (85%), median age 77 years (range 51-84) entered the study. Median follow-up time was 29 months (range 18-103 months). There were 63 controls (34%). Fourteen percent of the patients reported that radiotherapy had moderate to severe impact on their present bladder function. Compared with the control group, significantly more patients had dysuria, and urethral stenosis, and were using bladder catheter. Twenty-nine percent of the patients reported moderate to severe impact on their present bowel function. Significantly more patients had diarrhoea, fecal urgency and fecal incontinence, and were using antidiarrhoea medication and sanitary pads. Twenty-five percent of the patients reported moderate to severe impact on their present sexual function. Impotence and lack of sexual desire were significantly higher among the male patients.

Following radical radiotherapy, most patients had a well functioning bladder, whereas 14% reported moderate to severe bladder dysfunctions. Due to the presence of bowel in the treatment field, radiotherapy is associated with considerable long-term intestinal side effects. Moreover, radiotherapy may result in sexual dysfunctions.