The relationship between endometrial cancer and urinary incontinence: systematic review

The most common gynecological cancer in industrialized countries is endometrial cancer (EC), whose prevalence is growing and is associated with metabolic syndrome and obesity. Women's quality of life is negatively impacted by the common and upsetting disorder known as urinary incontinence (UI), particularly in postmenopausal and post-surgical populations. Despite plausible biological and iatrogenic connections between EC and UI-including shared risk factors such as obesity and the impact of hysterectomy on pelvic anatomy-the relationship remains inadequately synthesized in the literature.

The purpose of this systematic review is to summarize the data about the connection between endometrial cancer and incontinence, looking at prevalence, potential etiological mechanisms, and implications for clinical care.

A comprehensive search for English-language studies published in the last ten years was done using PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library. MeSH phrases and keywords associated with urinary incontinence and endometrial cancer were used in the search. Two reviewers used Rayyan software to independently pick studies, extract data, and evaluate quality. Because the studies were so different from one another, a narrative synthesis technique was used.

Six studies comprising 955 patients and 85 healthcare professionals met inclusion criteria. The collective evidence reveals that UI is a highly prevalent yet often undermanaged consequence of EC and its treatments. Findings demonstrate that lymph node dissection may contribute to urinary symptoms, though not reaching statistical significance. Radiotherapy exhibits paradoxical effects-potentially improving stress UI while contributing to broader pelvic floor dysfunction through radiation-induced fibrosis and measurable alterations in pelvic floor muscle properties. Obesity and age, rather than radiation exposure consistently, become important risk factors on their own.

Due to common risk factors, direct effects of the disease, and damage from therapy, urinary incontinence is a common and clinically important side effect of endometrial cancer and its therapies. As the number of EC survivors keeps rising, addressing UI must become a priority in comprehensive survivorship care. Future efforts should focus on developing validated screening tools, establishing evidence-based management guidelines, and implementing integrated care models.