Urinary and fecal incontinence in patients with advanced ovarian cancer treated with CRS + HIPEC

Surg Oncol. 2021 Mar:36:115-119. doi: 10.1016/j.suronc.2020.12.001. Epub 2020 Dec 11.

Abstract

Purpose: The objective of this work was to analyze the long-term prevalence of urinary and fecal incontinence and their impact on quality of life in patients with advanced and recurrent ovarian cancer treated with cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemotherapy (CRS + HIPEC).

Methods: This cross-sectional study included a series of patients with advanced and recurrent ovarian cancer treated by CRS + HIPEC, with a disease-free period of at least 12 months after the procedure. Urinary incontinence was evaluated using the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF), fecal incontinence using the Wexner test and the Fecal Incontinence Quality of Life (FIQL) questionnaire and global quality of life using the Short Form 36 (SF-36) survey.

Results: A total of 64 patients were included in the study, with a median age of 55 years (range 28-78). The urinary incontinence rate was 45% and the fecal incontinence rate was 20%. Up to 14% of the patients presented both types of incontinence. The presence of urinary or fecal incontinence generated a significant negative impact on quality of life in relation to patients without incontinence.

Discussion: Urinary and fecal incontinence is frequent in the follow-up of ovarian cancer patients treated with CRS + HIPEC. Reconsidering the approach to the pelvis without peritoneal metastases in the peritoneum could modify the incidence of these pelvic floor dysfunctions.

Keywords: Cytoreductive surgery; Fecal incontinence; HIPEC; Ovarian cancer; Urinary incontinence.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Chemotherapy, Cancer, Regional Perfusion / adverse effects*
  • Combined Modality Therapy
  • Cross-Sectional Studies
  • Cytoreduction Surgical Procedures / adverse effects*
  • Fecal Incontinence / etiology
  • Fecal Incontinence / pathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperthermia, Induced / adverse effects*
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / therapy*
  • Peritoneal Neoplasms / secondary
  • Peritoneal Neoplasms / therapy
  • Prognosis
  • Quality of Life*
  • Urinary Incontinence, Urge / etiology
  • Urinary Incontinence, Urge / pathology*