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International Journal of Colorectal Disease

Published in:

01-04-2013 | Original Article

Impact of late anorectal dysfunction on quality of life after pelvic radiotherapy

Authors: Robin Krol, Robert Jan Smeenk, Emile N. J. T. van Lin, Wim P. M. Hopman

Published in: International Journal of Colorectal Disease | Issue 4/2013

Abstract

Purpose

Anorectal dysfunction is common after pelvic radiotherapy. This study aims to explore the relationship of subjective and objective anorectal function with quality of life (QoL) and their relative impact in patients irradiated for prostate cancer.

Methods

Patients underwent anal manometry, rectal barostat measurement, and completed validated questionnaires, at least 1 year after prostate radiotherapy (range 1–7 years). QoL was measured by the Fecal Incontinence Quality of Life scale (FIQL) and the Expanded Prostate Cancer Index Composite Bowel domain (EPICB)-bother subscale. Severity of symptoms was rated by the EPICB function subscale.

Results

Anorectal function was evaluated in 85 men. Sixty-three percent suffered from one or more anorectal symptoms. Correlations of individual symptoms ranged from r = 0.23 to r = 0.53 with FIQL domains and from r = 0.36 to r = 0.73 with EPICB bother scores. They were strongest for fecal incontinence and urgency. Correlations of anal sphincter pressures, rectal capacity, and sensory thresholds ranged from r = 0.00 to r = 0.42 with FIQL domains and from r = 0.15 to r = 0.31 with EPICB bother scores. Anal resting pressure correlated most strongly. Standardized regression coefficients for QoL outcomes were largest for incontinence, urgency, and anal resting pressure. Regression models with subjective parameters explained a larger amount (range 26–92 %) of variation in QoL outcome than objective parameters (range 10–22 %).

Conclusions

Fecal incontinence and rectal urgency are the symptoms with the largest influence on QoL. Impaired anal resting pressure is the objective function parameter with the largest influence. Therefore, sparing the structures responsible for an adequate fecal continence is important in radiotherapy planning.

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Title: Impact of late anorectal dysfunction on quality of life after pelvic radiotherapy
Authors: Robin Krol
Robert Jan Smeenk
Emile N. J. T. van Lin
Wim P. M. Hopman
Publication date: 01-04-2013
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 4/2013
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-012-1593-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of late anorectal dysfunction on quality of life after pelvic radiotherapy

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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