Int Urol Nephrol. 2025 Aug 19. doi: 10.1007/s11255-025-04724-7. Online ahead of print.
ABSTRACT
BACKGROUND: Lower urinary tract dysfunction (LUTD) is a potential late effect in childhood cancer survivors, often overlooked in survivorship care. Neurotoxic chemotherapy, pelvic tumors, and radiation exposure may contribute to its development.
OBJECTIVES: To determine the prevalence and severity of LUTD in childhood cancer survivors and identify associated risk factors.
METHODS: A prospective observational study was conducted over six months among 92 childhood cancer survivors aged ≥ 5 years to 10 years. Participants were screened using the LUTD Scoring System (DVSS). A score ≥ 9 in males and ≥ 6 in females was considered diagnostic of LUTD. Clinical and treatment-related variables were extracted from medical records and analyzed for associations. Uroflowmetry and ultrasonography were performed in children with abnormal DVSS to further assess voiding pattern and bladder parameters.
RESULTS: LUTD was identified in 20 of 92 participants (21.7%), with a higher prevalence in females (31.6%) compared to males (14.8%), though this difference was not statistically significant (p = 0.073). Significant associations were observed with pelvic tumors (p = 0.002; Φ = 0.394), pelvic irradiation (p < 0.001; Φ = 0.455), Vinca alkaloid use (p = 0.035; Φ = 0.307), and high cumulative alkylating agent dose (> 8000 mg/m2) (p = 0.017; Φ = 0.267). Uroflowmetry confirmed abnormal voiding patterns in 95% of DVSS-positive patients. Most cases were managed conservatively with bladder training, while a subset required anticholinergics or laxatives.
CONCLUSION: LUTD is prevalent among childhood cancer survivors, particularly those exposed to Vinka alkaloids and pelvic-directed therapies. Routine LUTD screening using DVSS should be integrated into long-term follow-up protocols for early detection and intervention.
PMID:40828499 | DOI:10.1007/s11255-025-04724-7
