Urologic complications of pelvic irradiation

We evaluated 964 patients who had undergone radiation therapy for malignant disease of the pelvic viscera during a 5-year period and who ahd been followed for 5 to 10 years after completion of treatment. Therapy had been given for gynecological tumors in 493 cases, genitourinary tumors in 240 cases, bowel tumors in 172 cases and various other malignant tumors in the pelvis in 59 cases. The incidence of cystitis, hematuria, ureteral obstruction and fistula formation was determined for each group. There were 203 urological complications, an incidence of 21 per cent, but only 25 of these complication (2.5 per cent) could be ascribed to the effects of radiation alone, the remainder being associated with persistent or recurrent tumor. Approximately 20 per cent of the patients had some abnormalities detected in the pre-treatment excretory urogram. The development of urologic complications was related to the radiation dosage and previous bladder operations.