Urological complications after radical hysterectomy with or without radiotherapy for cervical cancer

We reviewed urologic complications in 320 patients who underwent radical abdominal hysterectomy for stage Ib-IIb cervical cancer. 145 patients received adjuvant radiotherapy, and 116 were available for urodynamic testing 1-14 years later. The overall incidence of fistulas was 4.4%. Three of eight fistulas following surgery alone healed spontaneously; all fistulas following adjuvant radiotherapy required surgical correction. Nocturia and urgency were reported more often after adjuvant radiotherapy than after surgery alone. We conclude that urologic complications after radical hysterectomy can be made more intractable by adjuvant radiotherapy.