Urological Complications And Impact On Quality Of Life Among Patients With Cervical Cancer At Kenyatta National Hospital

Abstract

Cervical cancer whose main etiology is HPV remains a major health issue globally especially in the developing world. About 270,000 women die annually due to cervical cancer; 88% of them in low income settings. In Kenya, it is the second common cancer after breast cancer in women, with an estimated incidence of 2,454 per 100,000 and a leading cause of death due to gynecological malignancy. Urologic complications— which include urinary tract infections, VVF, ureteric obstruction, stress and urge incontinence, hydronephrosis, and renal failure are very common in cervical cancer patients. They increase the morbidity and mortality in women and negatively impact their quality of life. Materials and Methods: A descriptive, cross sectional study involving 239 cervical cancer patients was conducted at Kenyatta National Hospital (KNH) between May and August 2012. A structured questionnaire aimed at understanding the burden of the urological complications, its associated factors and impact on quality of life was administered. Results: A total of 239 participants were interviewed. The prevalence of urologicalcomplications was 78%. The urological conditions included; UTI (55.1%), Urge incontinence (42.7%), Cystitis (37.2%), Hydronephrosis (37%) stress incontinence (26.8%), urinary retention (20.1%), hematuria (12.6%)and VVF (10%). There was a strong association between cancer staging and UTI (p=0.002). High parity (>3) was associated with development of stressincontinence (p=0.06).The median for the urinary distress inventory and incontinenceimpact questionnaire was 21.875 and 4.17 respectively. Conclusion: There is a highprevalence of urological complications Clinicians should routinely ask the patients on urological symptoms.