Brachytherapy induced uroincontinence is a well known but infrequent (4.4%) result of therapy.
Whereas the post surgical result , often including radiation Rx may be 11-12% .
PaceyCuff urethral control device may be used in both forms of the complication.
paceycuff.com
Whereas the post surgical result , often including radiation Rx may be 11-12% .
PaceyCuff urethral control device may be used in both forms of the complication.
paceycuff.com
Urology. 2016 Sep;95:151-7. doi: 10.1016/j.urology.2016.05.021. Epub 2016 May 19.
paceycuff.com
Urinary Incontinence Following Prostate Brachytherapy.
OBJECTIVE:
To define the incidence, time course, and risk factors associated with the
development of urinary incontinence (UI) following prostate brachytherapy.
development of urinary incontinence (UI) following prostate brachytherapy.
MATERIALS AND METHODS:
A total of 2461 men were identified who underwent permanent
interstitial prostate brachytherapy with or without external
beam radiation therapy. We examined the relationship between clinical- and treatment-related
variables with the onset of UI, defined as leakage requiring pad usage, and further classified
as stress (SUI) or urge (UUI) predominant, using univariate and Cox proportional hazards
regression models. The changes in International Prostate Symptom Score and quality of life
domains were assessed from baseline to last follow, and examined by UI status.
interstitial prostate brachytherapy with or without external
beam radiation therapy. We examined the relationship between clinical- and treatment-related
variables with the onset of UI, defined as leakage requiring pad usage, and further classified
as stress (SUI) or urge (UUI) predominant, using univariate and Cox proportional hazards
regression models. The changes in International Prostate Symptom Score and quality of life
domains were assessed from baseline to last follow, and examined by UI status.
RESULTS:
Patients were followed for a median of 6.4 years (interquartile range 4.1-9.3).
UI was reported in 108 individuals (4.4%), at a median of 1.8 years
(interquartile range 5 months-4.4 years): 30 with SUI and 78 with UUI. Seventy-two men (66.7%)
reported using 1, 24 (22.2%) using 2, and 12 (11%) using ≥3 pads per day. On multivariate
analysis, post-implantation transurethral resection of the prostate, urinary retention,
external beam radiation therapy, and higher pretreatment International Prostate
Symptom Score were significantly associated with the development of SUI,
although transurethral resection of the prostate was the only significant risk factor
associated with SUI. Men experiencing UI reported greater declines in urinary
quality of life; however, no significant difference was observed between SUI and UUI.
UI was reported in 108 individuals (4.4%), at a median of 1.8 years
(interquartile range 5 months-4.4 years): 30 with SUI and 78 with UUI. Seventy-two men (66.7%)
reported using 1, 24 (22.2%) using 2, and 12 (11%) using ≥3 pads per day. On multivariate
analysis, post-implantation transurethral resection of the prostate, urinary retention,
external beam radiation therapy, and higher pretreatment International Prostate
Symptom Score were significantly associated with the development of SUI,
although transurethral resection of the prostate was the only significant risk factor
associated with SUI. Men experiencing UI reported greater declines in urinary
quality of life; however, no significant difference was observed between SUI and UUI.
CONCLUSION:
UI occurred in 4.4% of patients following prostate brachytherapy
and is more commonly urge-predominant in character. Distinct risk factors
exist for the development of UUI vs SUI. Urinary leakage requiring pad usage was associated
with declines in urinary QOL.
and is more commonly urge-predominant in character. Distinct risk factors
exist for the development of UUI vs SUI. Urinary leakage requiring pad usage was associated
with declines in urinary QOL.
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