[Necrotic bladder following radiotherapy for cervical carcinoma]

Area of Science:

• Urology
• Oncology
• Radiotherapy

Background:

• Pelvic radiation therapy for cervical cancer can lead to late, severe, and irreversible complications.
• While proctitis, vaginitis, and acute radiation cystitis are known, rarer complications like bladder necrosis and ureteral stenosis can occur.

Observation:

• A 66-year-old patient developed progressive renal failure 10 years post-radiotherapy for cervical cancer.
• Ultrasound revealed bilateral hydroureteronephrosis, ureterovesical junction narrowing, and bladder wall thickening.
• Bladder biopsy confirmed extensive necrosis, leading to a diagnosis of necrotic bladder with bilateral ureteral stenosis.

Findings:

• The patient presented with severe urological complications manifesting as a necrotic bladder and bilateral ureteral stenosis.
• These late-onset complications occurred without typical local symptoms, highlighting the insidious nature of radiation damage.
• Lifelong renal urinary drainage was necessitated due to the irreversible nature of the damage.

Implications:

• Late obstructive urological complications post-radiotherapy are rare but serious.
• While ultrasound can aid early detection to prevent renal function loss, its cost-effectiveness for routine screening is questionable due to low incidence and long-term manifestation.
• This case underscores the importance of recognizing and managing delayed, severe consequences of pelvic radiation therapy.