Urinary incontinence management in patients with primary endometrial cancer: a cross-sectional study by the European Network of Young Gynaecologic Oncologists (ENYGO)

Abstract

Objective: Urinary incontinence is a common issue yet frequently overlooked in patients with endometrial cancer, especially post-treatment. Both advanced age and obesity as shared risk factors for endometrial cancer and urinary incontinence compound this burden. We hypothesized that there is insufficient awareness and suboptimal integration of urinary incontinence management into endometrial cancer care. Methods: The European Network of Young Gynaecologic Oncologists (ENYGO) team conducted a cross-sectional online survey from February to November 2024 using SurveyMonkey, targeting healthcare professionals involved in gynecologic oncology care. The 31-item questionnaire covered demographics, diagnostics, treatment protocols, and urinary incontinence-related practices. Statistical analysis was performed using SPSS V28.0, including descriptive statistics, normality testing, and appropriate reporting of mean +/- SD or median with interquartile ranges. Results: Our final analysis included 85 complete responses. Respondents were from 31 countries, with a median age of 38 years, and 55.3% of them were female. Although 65.9% of institutions had urogynecologists, only 3.5% of respondents had formal urogynecology training. Urinary incontinence was most frequently discussed before surgery (27.1%) and least before targeted therapy (9.4%). Radiation therapy was identified by 75.4% as the main contributor to urinary incontinence. While 96.5% asked about urinary incontinence during follow-up, only 14.1% managed it post-treatment. Major barriers included lack of training (54.1%) and resources (31.8%). Notably, 58.8% expressed interest in further training. Conclusion: Despite high reported awareness of urinary incontinence, proactive assessment and management remain inconsistent in endometrial cancer care. Structured education, interdisciplinary collaboration, and guideline development are needed to optimize quality of life outcomes.