Fecal incontinence after prostate cancer irradiation: a systematic literature review.
Anal canal radiation dose above 37 Gy is linked to more fecal incontinence.
Fecal incontinence after prostate cancer irradiation: a systematic literature review.
Fecal incontinence (fecal incontinence) is an underrecognized but clinically significant late gastrointestinal toxicity following radiotherapy (radiotherapy) for prostate cancer.
This systematic review aimed to synthesize current knowledge on the definition and pathophysiology of post-radiation anal continence, as well as prevention strategies, technical considerations, and therapeutic approaches.
A systematic literature search was conducted according to PRISMA guidelines using the keywords: "Fecal incontinence," "Radiation therapy," and "Prostatic neoplasms." Eligible studies included randomized phase III trials and prospective or retrospective series reporting on fecal incontinence after definitive or adjuvant/salvage prostate radiotherapy.
Fecal incontinence after prostate radiotherapy results from functional, morphological, and neurogenic alterations of the anorectal system.
Reported incidence ranges from 1 to 12%, most often presenting as flatulence or liquid stool leakage, while severe forms requiring pads are uncommon.
Variability is largely explained by heterogeneity in definitions and assessment tools, as no standardized scoring system is universally applied.
Risk factors include advanced age, prior abdominal surgery, vascular comorbidities, chronic inflammatory bowel disease, hemorrhoids, and rectal urgency during radiotherapy.
Fecal incontinence after prostate radiotherapy is likely underestimated due to the absence of a standardized assessment.
Developing a validated, universally applicable scoring system is a priority to improve evaluation, enable cross-study comparisons, refine preventive measures, and guide therapeutic strategies.