scholarly journals Radiation induced vesicovaginal fistula

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Kenusha Devi Tiwari
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Radiation Therapy ◽  
Radical Hysterectomy ◽  
Vesicovaginal Fistula ◽  
Fistula Repair ◽  
Pelvic Radiation ◽  
Radiation Induced

Case: A 63 years old female visited our outpatient department for involuntary loss of urine per vagina since 1.5 year. She had undergone radical hysterectomy and radiotherapy 16 years ago for cervical carcinoma. With positive dye test, on examination she had vesicovaginal fistula with Goh classification of 2biii. She underwent fistula repair via vaginal approach. After 3 weeks of catheterization, successful closure was achieved. Radiation therapy is an effective treatment for cervical cancer. However, of various complications, irradiation sometimes cause the formation of fistula between vagina and bladder and or rectum compromising the quality of life. Pelvic radiation is the primary cause of delayed vesicovaginal fistula with incidence of 13%. Majority of them become apparent 1.5-2 year after termination of radiotherapy and can occur even up-to 20-30 years after the original insult. Keywords: cervical cancer, fistula, radiation induced

scholarly journals Vesicovaginal Fistula After Fourteen Years of Pelvic Radiation

2018 ◽  
Vol 13 (2) ◽  
pp. 60-62
Author(s):  
Kenusha Devi Tiwari ◽  
Aruna Karki ◽  
Ganesh Dangal ◽  
Hema Pradhan ◽  
Ranjana Shrestha ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Radiation Therapy ◽  
Radical Hysterectomy ◽  
Vesicovaginal Fistula ◽  
Fistula Repair ◽  
Pelvic Radiation ◽  
Advanced Cervical Carcinoma

Radiation therapy is an effective treatment for cervical cancer. However, of various complications, irradiation sometimes can cause formation of fistula between vagina and bladder and or rectum compromising the quality of life. Pelvic radiation is the primary cause of delayed vesicovaginal fistula with incidence of 13% in well-resourced countries and 0.2% in low resourced countries. Majority of them become apparent 1.5-2 years after completion of radiotherapy and can occur even up-to 20-30 years after the original insult. A 63 years’ female visited our outpatient department for involuntary loss of urine per vagina for 1.5 years. She had undergone radical hysterectomy and radiotherapy 16 years ago for an advanced cervical carcinoma. With positive dye test, she had vesicovaginal fistula with Goh classification of 1biii. She underwent simple fistula repair via vaginal approach. After three weeks of catheterization, successful closure was achieved.

scholarly journals Robot-Assisted Infratrigonal Vesicovaginal Fistula Repair

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
João Pádua Manzano ◽  
Fábio da Silva Crochik ◽  
Felipe Guimarães Pugliesi ◽  
Renato Vasconcelos Souza de Almeida ◽  
Petronio Augusto de Souza Melo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Vesicovaginal Fistula ◽  
Fistula Repair ◽  
Robot Assisted ◽  
Disease Treatment ◽  
Case Presentation ◽  
Genitourinary Fistula ◽  
Vesicovaginal Fistulas

Background. Although relatively rare, vesicovaginal fistula is the most common genitourinary fistula, causing a significant decrease in patients’ quality of life. Location of fistula is major supratrigonal, with some cases located in the trigone and rarely below it. Disease treatment is surgical, and repair can be performed by several techniques, including robot-assisted. Case Presentation. We present a case of a patient who developed an infratrigonal vesicovaginal fistula after treatment of a cervical cancer. The patient was submitted to robotic repair of the vesicovaginal fistula. Conclusion. The use of robot-assisted laparoscopy is expanding over all areas of urology and its applicability to repair vesicovaginal fistulas brings good results.

scholarly journals Predictive factors of posttreatment fracture by definitive radiotherapy for uterine cervical cancer

2020 ◽  
Author(s):  
Kazuki Ishikawa ◽  
Tsuneo Yamashiro ◽  
Takuro Ariga ◽  
Takafumi Toita ◽  
Wataru Kudaka ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Cervical Cancer ◽  
Multivariate Analysis ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Clinical Characteristics ◽  
Univariate Analysis ◽  
Uterine Cervical Cancer

Abstract Purpose Fractures are known to shorten life expectancy and worsen the quality of life. The risk of fractures after radiation therapy in cervical cancer patients is known to be multifactorial. In this study, we examined risk factors for fractures in cervical cancer patients, especially by evaluating bone densities and DVH parameters for fractured bones. Materials and Methods For 42 patients, clinical characteristics, pretreatment CT bone densities, and radiation dose were compared between patients with and without fractures. Results Posttreatment fractures occurred in 25 bones among ten patients. Pretreatment CT bone densities were significantly lower in patients with fractures (P < 0.05–0.01 across sites, except for the ilium and the ischium). Although DVH parameters were also significantly associated with fractures in univariate analysis, only CT densities were significantly associated with fractures in multivariate analysis. Conclusion Pretreatment CT densities of spinal and pelvic bones, which may reflect osteoporosis, have a significant impact on the risk for posttreatment fractures.

scholarly journals Personal innovative approach in radiation therapy of lung cancer- functional lung avoidance SPECT-guided (ASPECT) radiation therapy: a study protocol for phase II randomised double-blind clinical trial

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Azza Ahmed Khalil ◽  
Eric Hau ◽  
Val Gebski ◽  
Cai Grau ◽  
Harriet Gee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Clinical Trial ◽  
Radiation Therapy ◽  
Radiation Dose ◽  
Pulmonary Toxicity ◽  
Double Blind ◽  
Curative Intent ◽  
Radiation Induced

Abstract Background Radiation therapy (RT) plays a key role in curative-intent treatment for locally advanced lung cancer. Radiation induced pulmonary toxicity can be significant for some patients and becomes a limiting factor for radiation dose, suitability for treatment, as well as post treatment quality of life and suitability for the newly introduced adjuvant immunotherapy. Modern RT techniques aim to minimise the radiation dose to the lungs, without accounting for regional distribution of lung function. Many lung cancer patients have significant regional differences in pulmonary function due to smoking and chronic lung co-morbidity. Even though reduction of dose to functional lung has shown to be feasible, the method of preferential functional lung avoidance has not been investigated in a randomised clinical trial. Methods In this study, single photon emission computed tomography (SPECT/CT) imaging technique is used for functional lung definition, in conjunction with advanced radiation dose delivery method in randomised, double-blind trial. The study aims to assess the impact of functional lung avoidance technique on pulmonary toxicity and quality of life in patients receiving chemo-RT for lung cancer. Eligibility criteria are biopsy verified lung cancer, scheduled to receive (chemo)-RT with curative intent. Every patient will undergo a pre-treatment perfusion SPECT/CT to identify functional lung. At radiation dose planning, two plans will be produced for all patients on trial. Standard reference plan, without the use of SPECT imaging data, and functional avoidance plan, will be optimised to reduce the dose to functional lung within the predefined constraints. Both plans will be clinically approved. Patients will then be randomised in a 2:1 ratio to be treated according to either the functional avoidance or the standard plan. This study aims to accrue a total of 200 patients within 3 years. The primary endpoint is symptomatic radiation-induced lung toxicity, measured serially 1–12 months after RT. Secondary endpoints include: a quality of life and patient reported lung symptoms assessment, overall survival, progression-free survival, and loco-regional disease control. Discussion ASPECT trial will investigate functional avoidance method of radiation delivery in clinical practice, and will establish toxicity outcomes for patients with lung cancer undergoing curative chemo-RT. Trial registration Clinicaltrials.gov Identifier: NCT04676828. Registered 1 December 2020.

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