A rare case of post radiation urinary bladder necrosis in a patient with carcinoma cervix

Abstract

In contrast to proctitis, vaginitis and acute radiation cystitis, late urological complications after pelvic irradiation are rarer, more serious and irreversible. The main disadvantage of radiotherapy is the fact that it affects both cancer and healthy cells located in the tumour area. As a consequence, different complications develop. A large proportion of cancers treated with radiotherapy are located in the lower abdomen and pelvis, which is why complications often involve the urinary tract. Due to the anatomy of these areas, urological complications occur not only after radiological treatment of urological cancers, but also after treatment of malignancies of the reproductive or digestive system. The most common radiation-induced complications include haemorrhagic cystitis, urethral and ureteral strictures, urinary fistulae, and secondary primary malignancies. Because of impaired tissue healing, the treatment of radiation urological complications is a challenge for urologists and often requires complicated reconstruction techniques. We hereby described an elderly woman who is a known case of carcinoma of cervix with post radical hysterectomy and post pelvic radiotherapy status presented with fever, pain abdomen, vomiting, obstipation, voiding difficulties with dysuria on admission, which was diagnosed as acute intestinal obstruction with post radiation bladder necrosis with acute kidney injury. This case is a rare example of high-grade late adverse events which occurred 8 yrs after radiation therapy in a known case of carcinoma of cervix.