ABSTRACT
Sexual and urinary morbidities resulting from treatment of pelvic malignancies are common. These treatment sequelae are significantly bothersome to patients and challenging to address. Awareness of these complications is critical in order to properly counsel patients regarding potential side effects and to facilitate prompt diagnosis and management. Addressing these issues often necessitates a coordinated multidisciplinary approach; however, the effort required often translates into improvement in patient quality of life. Herein we review the sexual and urinary side effects that may arise during or after treatment of pelvic malignancies.
Subject(s)
Cancer Survivors/psychology , Pelvic Neoplasms/therapy , Humans , Pelvic Neoplasms/mortality , Pelvic Neoplasms/psychology , Quality of Life , Sexual Dysfunctions, Psychological/therapy , Urinary Incontinence, Stress/therapySubject(s)
Osteomyelitis/epidemiology , Prostatic Neoplasms/radiotherapy , Pubic Bone/radiation effects , Radiation Injuries/epidemiology , Radiotherapy, Adjuvant/adverse effects , Survivors , Urinary Fistula/epidemiology , Humans , Male , Osteomyelitis/diagnostic imaging , Osteomyelitis/surgery , Prostatectomy , Prostatic Neoplasms/epidemiology , Prostatic Neoplasms/surgery , Pubic Bone/diagnostic imaging , Pubic Bone/surgery , Radiation Injuries/diagnostic imaging , Radiation Injuries/surgery , Risk Assessment , Risk Factors , Treatment Outcome , Urinary Fistula/diagnostic imaging , Urinary Fistula/surgeryABSTRACT
OBJECTIVE: Urinary tract infections (UTIs) are a common source of morbidity among children with spina bifida (SB) and are a frequently reported outcome in studies of this patient population. However, the criteria for a diagnosis of UTI are often not stated. We evaluated the literature on SB patients for the criteria that authors use to define parameters in reporting UTI outcomes. METHODS: Embase and Medline were queried with the medical subject heading terms "spinal dysraphism," "myelomeningocele," "infection,"and "urinary tract infection." A second search with the exploded term"spina bifida" and "urinary tract infection" was performed. Original research studies reporting a UTI outcome in SB patients were included and evaluated by 2 independent reviewers for the presence of a UTI definition and diagnostic criteria. RESULTS: We identified 872 publications, of which 124 met inclusion criteria. Forty-five of 124 (36.3%) studies reporting UTI as an outcome provided a definition of UTI. Of 124 studies, 28 (22.6%) were published in pediatric journals and 69 (55.6%) in urology journals. A definition of UTI was provided in 11 (39.3%) and 26 (37.7%) studies, respectively. "Fever,culture, and symptoms" defined a UTI in 17 of 45 studies. Journal category and presence of UTI definitions did not correlate (P = .71). CONCLUSIONS: Explicit definitions for UTI are heterogeneous and infrequently applied in studies of SB patients, limiting study reliability and estimates of true UTI rates in this population. Future studies will benefit from the development and application of a standard definition for UTI in this population.
