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Urinary side effects and complications after permanent prostate brachytherapy: the MD Anderson Cancer Center experience.

Abstract：

OBJECTIVES:To evaluate acute and long-term urinary morbidity after permanent prostate brachytherapy at a single tertiary care center. To minimize the risk of long-term urinary morbidity, it is important for clinicians to be able to distinguish acute urinary side effects after prostate brachytherapy from longer-term treatment-related urinary complications. METHODS:The medical records of 351 consecutive patients who underwent prostate brachytherapy at the MD Anderson Cancer Center between 1998 and 2006 were analyzed. To evaluate the short-term urinary side effects, the Expanded Prostate Cancer Index Composite questionnaire was administered at baseline and at 1, 4, 8, and 12 months. Long-term urinary complications were scored using a modified Radiation Therapy Oncology Group scale. RESULTS:All 4 urinary subdomain scores evaluating acute urinary side effects after treatment (bother, function, incontinence, and irritation or obstruction) had returned to baseline levels by 8 months after implantation. At 5 years, the cumulative risks of late urinary complications by grade were 8.6% for grade 1 complications, 6.5% for grade 2, 1.7% for grade 3%, and 0.5% for grade 4. The most common grade 2 late urinary complications were urethral stricture (4 patients), incontinence requiring daily pads (3 patients), and intermittent hematuria (3 patients). Grade 3 complications were urinary retention requiring self-catheterization (2 patients) and severe frequency with dysuria (2 patients). The only grade 4 event was severe hemorrhagic cystitis. CONCLUSIONS:Short-term urinary side effects after prostate brachytherapy are common, follow a predictable course, and typically resolve within 1 year. Conservative management of short-term urinary side effects is recommended to minimize the risk of long-term urinary complications.

journal_name

Urology

journal_title

Urology

authors

Anderson JF,Swanson DA,Levy LB,Kuban DA,Lee AK,Kudchadker R,Phan J,Bruno T,Frank SJ

doi

10.1016/j.urology.2009.04.060

subject

Has Abstract

pub_date

2009-09-01 00:00:00

pages

601-5

issue

3

eissn

0090-4295

issn

1527-9995

pii

S0090-4295(09)00611-6

journal_volume

74

pub_type

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