Managing Urinary and Bowel Issues After Chemotherapy for Cervical Cancer

Abnormal bowel and bladder function after electrotherapy?

Hello, Dr.
Chen.
My mother (56 years old) underwent a total hysterectomy along with bilateral salpingo-oophorectomy and pelvic lymphadenectomy three years ago due to cervical cancer.
She subsequently received chemotherapy and radiation therapy.
Since then, she has experienced difficulty controlling her urination (often feels the urge but cannot empty her bladder completely, and sometimes leaks urine when laughing) and relies on over-the-counter laxatives to relieve severe abdominal pain caused by constipation, which can last for several days.

1.
She has been consuming a high-fiber diet, taking probiotics, and engaging in abdominal massage and exercise, yet she still cannot have regular bowel movements.

2.
Additionally, her stools have a very foul odor.
I would like to ask the doctor what methods could help improve my mother's bowel issues.
Thank you!

bs, 30~39 year old female. Ask Date: 2009/10/24

Dr. Chen Junyi reply Oncology

The cause is likely related to complications from abdominal cancer treatment.
Intestinal probiotics may be considered, and it is advisable to seek assistance from a professional physician in person.

Reply Date: 2009/10/24

More Info

Managing urinary and bowel issues after chemotherapy for cervical cancer can be quite challenging, especially given the surgical interventions and treatments your mother has undergone. It’s important to understand that both urinary and bowel dysfunction can be common side effects of cancer treatments, including surgery and chemotherapy. Here’s a comprehensive approach to address these issues.

Urinary Issues
1. Incontinence and Urgency: After a hysterectomy and lymph node removal, many women experience changes in bladder control. This can manifest as urgency, frequency, and incontinence, especially during activities that increase abdominal pressure, such as laughing or coughing.
- Pelvic Floor Exercises: Kegel exercises can strengthen the pelvic floor muscles, which may help improve bladder control. A physical therapist specializing in pelvic health can provide guidance on proper techniques.

- Bladder Training: This involves scheduling bathroom visits and gradually increasing the time between them to train the bladder to hold more urine.

- Medications: There are medications available that can help manage urgency and frequency. Anticholinergics or beta-3 adrenergic agonists are commonly prescribed for overactive bladder symptoms.

2. Dietary Considerations: Certain foods and drinks can irritate the bladder. It may be beneficial to keep a food diary to identify any potential triggers, such as caffeine, alcohol, or spicy foods.

Bowel Issues
1. Constipation: Given that your mother is already consuming high-fiber foods and probiotics, it may be necessary to explore additional options.
- Hydration: Ensure she is drinking plenty of fluids, as dehydration can exacerbate constipation.

- Laxatives: If over-the-counter options are not effective, a healthcare provider may prescribe stronger laxatives or stool softeners. It’s important to use these under medical supervision to avoid dependency.

- Regular Exercise: Gentle physical activity can stimulate bowel function. Encourage her to engage in regular, light exercise, such as walking.

2. Smell and Stool Quality: The foul odor of stool can be influenced by diet, hydration, and gut health.
- Probiotics: Continuing with probiotics may help improve gut flora, which can enhance digestion and reduce odor.

- Dietary Adjustments: Foods that are high in sulfur (like broccoli and cabbage) can contribute to odor. Reducing these may help. Additionally, incorporating more fruits and vegetables can improve stool consistency and reduce odor.

Seeking Professional Help
Given the complexity of your mother’s situation, it is crucial to involve healthcare professionals in her care. A gastroenterologist can provide specialized advice for bowel issues, while a urologist or a pelvic floor specialist can address urinary concerns.

Psychological Support
Lastly, the emotional and psychological impact of these changes should not be overlooked. Consider counseling or support groups for both your mother and your family, as coping with the aftermath of cancer treatment can be challenging.

In summary, while urinary and bowel issues can be distressing after chemotherapy and surgery for cervical cancer, there are various strategies and treatments available. A multidisciplinary approach involving diet, exercise, medications, and professional support can significantly improve your mother’s quality of life. Always consult with her healthcare team before making any changes to her treatment plan.

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