title: [Necrotic bladder following radiotherapy for cervical carcinoma].
abstract: BACKGROUND
  In contrast to proctitis, vaginitis and acute radiation cystitis are late complications of pelvic radiation therapy, rare, more severe and irreversible.
  
  
  METHODS
  A 66-year-old patient presented with progressive renal failure ten years after radiotherapy for carcinoma of the cervix. Ultrasound investigation revealed a bilateral hydroutereronefrosis (grade 4), with narrowing of the ureterovesical junctions and a diffuse thickening of the urinary bladder wall. Biopsy of the bladder wall showed extended necrosis. The diagnosis was a necrotic bladder with bilateral ureteral stenosis without local symptoms. Lifelong renal urinary drainage was indicated.
  
  
  CONCLUSIONS
  Late obstructive urological complications, such as bladder necrosis and urethral obstruction, are rare following radiotherapy for cervical carcinoma. Ultrasound follow-up can contribute to the early detection of these complications and intervention can prevent further loss of renal function; however, this would not be cost-effective because of the low incidence rate and because these complications appear in the long term.
authors.affiliation: Atrium MC, afd. Urologie, Heerlen, the Netherlands. t.hermans@student.maastrichtuniversity.nl
authors.forename: Tom J N
authors.initials: TJ
authors.lastname: Hermans
authors.forename: Karl P J
authors.initials: KP
authors.lastname: Delaere
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: Mens
authors.forename: Mark L
authors.initials: ML
authors.lastname: Paffen
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D009336:Necrosis; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000175:diagnosis / Q000209:etiology; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000209:etiology; D001743:Urinary Bladder / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*