Reconstructive Urology & Men's Health

Radiation Injuries

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What is a radiation injury?

Radiation has diverse applications in the treatment of cancer. It is used to treat gynecologic cancer (ovaries, cervix, uterine, vaginal), childhood cancers, colorectal cancer and cancers in the genito-urinary system (prostate, testis and bladder). While radiation can help cure these cancers it can also damage the tissue that surrounds the cancer. This damage often accumulates over time and can lead to severe scarring of the internal organs and vital structures that surround the area that was radiated. It is this scarring and damage that leads to the complications seen in patients with radiation injury. These complications can occur a short time after radiation or more commonly occur years or even decades after the radiation was received.

What are some of the common problems after radiation?

The complications after radiation depend upon the dose of radiation and where the energy was focused in the body. Radiation that was given in the abdomen for gynecologic, testicular or pediatric cancers can cause scarring of the kidney or the ureters (the urinary tubes connecting the kidney to the bladder). Radiation that was given in the pelvis for problems like prostate, bladder, colorectal and cervical cancer can damage many of the urinary structures. Common problems from pelvic radiation are strictures of the urethra, fistula (a hole between the bladder or urethra and the rectum or skin), incontinence and a contracted, low capacity bladder.

How are radiation injuries treated?

The treatment of radiation damage depends upon the nature of the problem. Chronic wounds can sometimes be treated with a trial of hyperbaric oxygen. If there is a surgical problem, this can be addressed by a urologist. Surgery may involve a variety of procedures depending upon the nature of the problem. The damage can be so varied from radiation that each patient will need to have a thorough evaluation to find out the extent of damage and create a strategy to improve or fix the damage that has occurred. This evaluation often involves tests, like CT scans or scope procedures. Once the extent of the problem has been fully assessed, then a surgical strategy can be developed. Surgery after radiation damage is not easy and the complication rate is much higher, but it is often the only way to get patients back to a functional life.