Urinary incontinence in women with gynecologic malignancies before and after primary therapy

Abstract

9087 Background: There is limited data on the impact of treatment for gynecologic cancer on future urinary incontinence. Our objective is to determine degree of urinary incontinence in women previously treated for gynecologic cancer and women not yet treated. Methods: With IRB approval gynecologic cancer patients that had completed therapy over 1 year prior and those not yet receiving therapy were asked to participate. Consenting subjects completed the Incontinence Impact Questionnaire (IIQ) and Urogenital Distress Inventory (UDI). Both are scored from 0–100 with higher scores representing more incontinence. We also assessed general health. Mean scores were calculated and compared with adjustments for covariates. In established patients Kruskal-Wallis was used to test overall equality of IIQ and UDI across various diagnoses and treatments. Results: Ninety new patients and 104 established patients were enrolled. Age, parity, tobacco use and use of incontinence medications were similar between the groups. General health status was worse in the new patients (p<0.0001). Mean (± S.E.) IIQ scores were similar between new (6.87 ± 1.4) and established patients (4.76 ± 0.96), p=0.56. Mean UDI scores were also similar for new (17.2 ± 9.0) and established (13.2 ± 9.8) patients, p=0.20. After adjusting for health status, parity, age, tobacco use, prior use of incontinence medications there was no significant difference in either score. There was a significant positive association between age and incontinence as assessed by IIQ (p=0.02). We compared scores for established patients diagnosed with cervical, ovarian, uterine and vulvar cancer and found no significant difference in either IIQ (p=0.55) or UDI (p=0.76). Similarly there was no significant difference in scores for patients receiving hysterectomy, radical hysterectomy, BSO, vulvectomy, tumor debulking, chemotherapy or radiation therapy. Although not significant there was a trend toward more incontinence in patients having received radical hysterectomy. Conclusions: Urinary incontinence as measured by IIQ and UDI dose not appear to be different at the time of diagnosis of gynecologic cancer and a year from the completion of therapy. There is no apparent difference in urinary incontinence across diagnoses. No significant financial relationships to disclose.