title: Urinary incontinence and other pelvic floor disorders after radiation therapy in endometrial cancer survivors.
abstract: OBJECTIVE
  To investigate radiation therapy as a risk factor for urinary or fecal incontinence, pelvic organ prolapse, and sexual dysfunction in endometrial cancer survivors.
  
  
  METHODS
  We performed a retrospective cohort study of endometrial cancer survivors. Data were collected using a mailed survey and the medical record. Validated questionnaires were used to generate rates of urinary incontinence and other pelvic floor disorders. The incidence rates of pelvic floor disorders were compared across groups with different exposures to radiation.
  
  
  RESULTS
  Of the 149 endometrial cancer survivors, 41% received radiation therapy. Fifty-one percent of women reported urine leakage. The rates of urinary incontinence in women exposed and not exposed to vaginal brachytherapy (VBT) or whole-pelvis radiation were 48% and 58%, respectively (p=0.47). The incidence of fecal incontinence did not differ between groups, but the score for overall sexual function was significantly higher in women who did not undergo radiation therapy. On multivariable analysis, significant risk factors for urinary incontinence were age (AOR 1.06 95% CI 1.02, 1.10) and BMI (AOR 1.07 95% CI 1.02, 1.11), but treatment with radiation was not significantly associated with urinary incontinence, or fecal incontinence (p>0.05). Age, BMI, and radiation exposure were independent predictors of decreased sexual function score (p<0.01).
  
  
  CONCLUSIONS
  Local or regional radiation is not associated with urinary or fecal incontinence, but may contribute to sexual dysfunction in endometrial cancer survivors.
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, and Division of Urology, Department of Surgery, Rutgers - Robert Wood Johnson Medical School, New Brunswick, NJ, United States. Electronic address: sayasegal@hotmail.com.
authors.forename: Saya
authors.initials: S
authors.lastname: Segal
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, NY, United States.
authors.forename: Gabriella
authors.initials: G
authors.lastname: John
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, and Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.
authors.forename: Mary
authors.initials: M
authors.lastname: Sammel
authors.affiliation: Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania; Philadelphia, PA, United States.
authors.forename: Uduak Umoh
authors.initials: UU
authors.lastname: Andy
authors.affiliation: Division of Gynecologic Oncology, Fox Chase Cancer Center, Philadelphia, PA, United States.
authors.forename: Christina
authors.initials: C
authors.lastname: Chu
authors.affiliation: Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania; Philadelphia, PA, United States.
authors.forename: Lily A
authors.initials: LA
authors.lastname: Arya
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, and Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.
authors.forename: Justin
authors.initials: J
authors.lastname: Brown
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, and Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Schmitz
mesh_terms: D000368:Aged; D000073116:Cancer Survivors; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000532:radiotherapy; D005242:Fecal Incontinence / Q000453:epidemiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D059952:Pelvic Floor Disorders / Q000453:epidemiology*; D056887:Pelvic Organ Prolapse / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology
keywords: Endometrial cancer survivors; Fecal incontinence; Radiation therapy; Sexual dysfunction; Urinary incontinence