The incidence and treatment of intestinal and urological complications after combined radiotherapy for uterine carcinomas.

OPNE HUNDRED AND SIXTY-FOUR PATIENTS WITH GYNECOLOGICAL CARCINOMAS (104 ca colli uteri, 60 cacorporis uteri) were examined retrospectively two to seven years after combined internal-external radiotherapy. Thirty-seven per cent of the patients displayed mild intestinal symptoms during the therapy. The frequency of symptoms remained unchanged after the termination of therapy, though they tended to become more severe. Twenty-five per cent of the patients had urological symptoms during the therapy. Their rate remained the same during the arly follow-up, but increased subsequently, because the frequencies of infections and hematuria had increased. Fourteen patients developed a complication requiring operative treatment five to fifty-seven months after the discontinuation of therapy. Three of them had both intestinal and urological complications, while six had only urological complications. The intestinal complications were repaired with smallgut resections and colostomies, while the urological complications (ureteral strictures) were repaired with different diversion operations with good operative results. Thirteen of the patients with serious complications are alive. One patient had died of profuse rectovaginal bleeding. The mean radiation doses employed were not different in the group with serious complications. Evleven of the patients with complications suffered from different concurrent diseases, which may have diminished their radiation tolerance. The radiotherapy of gynecological malignancies ought to be preformed individually noticing the intestinal reactions during the therapy and the concurrent disease. The value of renography in early detection of urinary tract complications is stressed.