Fluid detection in the uterus during and after irradiation for carcinoma of the cervix--clinical implications.

The records of 16 patients with an obstructed, fluid-filled uterus due to carcinoma of the uterus or to its treatment by radiation therapy were analysed. In 12 uteri the presence of malignant tumor was simultaneously established, e.g. primary cervical carcinoma (1), recurrence of cervical (4), endometrial Stage II or III carcinoma (2), second primary tumors, MMT (2), and endometrial carcinoma (3). The uterine fluid consisted of blood (8), pus (3) or was serous (3). Twice the fluid could not be analysed. In our series the prognosis of patients with recurrent cervical cancer or a second primary tumor was poor. Improvement of the prognosis can result by intensifying the follow-up examinations with CT and/or ultrasound in the first 2 years, and not by prolongation of the follow-up period. Estrogen therapy was believed to be the causal factor in three cases of hemotometra. In the near future an increase of this complication is possible as a consequence of hormonal replacement therapy given to prevent osteoporosis after pelvic irradiation.