Cervical cancer (CC) is a malignancy that begins in the cells of the cervix, the lower part of the uterus connecting to the vagina. A Urinary Tract Infection (UTI) is a common bacterial infection affecting the urinary system. While these two conditions are distinct, cervical cancer can cause a UTI, primarily in advanced cases. The physical presence of the tumor begins to interfere with nearby organs, creating an environment susceptible to infection or producing symptoms that mimic a persistent UTI.
How Advanced Cervical Cancer Affects Urinary Function
The causal link between cervical cancer and urinary issues, including UTIs, primarily involves advanced stages of the disease. The cervix is located near the bladder and the ureters, which carry urine from the kidneys to the bladder. As a tumor grows, it can physically expand and press on these adjacent structures, a process known as local invasion. This compression can obstruct one or both ureters, preventing the normal flow of urine. The resulting backup of urine, called hydronephrosis, causes swelling. This obstruction leads to urinary stasis, where urine is held in the urinary tract for prolonged periods. Stagnant urine provides an ideal breeding ground for bacteria, significantly increasing the likelihood of a bacterial infection in the upper urinary tract.
Cervical Cancer Symptoms Often Mistaken for a UTI
Many symptoms of cervical cancer in its later stages can mirror those of a UTI. A standard UTI typically causes dysuria (pain or burning sensation during urination) and increased urinary frequency. Cervical cancer, however, can cause chronic pelvic pain, pressure, and general discomfort often misinterpreted as a urinary infection. The tumor’s growth and proximity to the bladder and rectum lead to a feeling of persistent pelvic heaviness or pressure. Some women with advanced CC also report needing to urinate more often or experiencing pain during urination, which overlaps with common UTI symptoms. The difference is that the urinary symptoms in CC are often caused by the tumor’s mass effect on the bladder, rather than a bacterial infection. Abnormal vaginal bleeding or discharge are more specific signs of cervical cancer to recognize alongside these urinary complaints.
Urinary Complications Related to Cervical Cancer Treatment
Beyond the effects of the tumor itself, treatments for cervical cancer can also lead to urinary tract dysfunction and an increased risk of UTIs.
Surgical Complications
Extensive surgical procedures, such as a radical hysterectomy, involve removing the uterus, cervix, and surrounding tissue. This can damage the autonomic nerves that control bladder function, resulting in voiding dysfunction where the bladder cannot empty properly. This often requires temporary catheterization. Prolonged use of a urinary catheter is a known risk factor for catheter-associated UTIs (CAUTIs) due to the easy route for bacteria to enter the bladder.
Radiation and Chemotherapy Effects
Chemoradiotherapy, a common treatment for advanced disease, can cause late-onset urological complications like radiation cystitis. Radiation cystitis is an inflammation of the bladder lining that decreases the bladder’s capacity and elasticity. This leads to frequent urination, urgency, and a higher susceptibility to chronic infection. In rare, severe cases, treatment can lead to the formation of a fistula, an abnormal connection between the vagina and the bladder or rectum, which introduces bacteria and causes recurrent infections.
Prevention and Early Detection of Cervical Cancer
Since urinary complications are associated with advanced disease, prevention and early detection of cervical cancer are paramount. The primary cause of nearly all cervical cancers is persistent infection with high-risk types of the Human Papillomavirus (HPV). The HPV vaccine offers primary prevention against the virus and is recommended for both boys and girls, ideally between the ages of nine and twelve, before potential exposure.
Regular screening is the most effective method for early detection, allowing for the identification and treatment of precancerous cell changes before they become invasive. Screening typically begins at age 25. Adherence to these schedules allows health providers to find and treat abnormalities when they are highly curable, preventing the development of advanced cervical cancer that could compromise urinary function.
Screening options include:
- A primary HPV test every five years.
- A combination of HPV and Pap testing (co-testing) every five years.
- A Pap test alone, which looks for abnormal cervical cells, every three years.