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Risk of urinary incontinence following post-brachytherapy transurethral resection of the prostate and correlation with clinical and treatment parameters.
J Urol. 2013 Nov; 190(5):1805-10.JU

Abstract

PURPOSE

We assess the risk of urinary incontinence after transurethral prostate resection in patients previously treated with prostate brachytherapy.

MATERIALS AND METHODS

A total of 2,495 patients underwent brachytherapy with or without external beam radiation therapy for the diagnosis of prostate cancer between June 1990 and December 2009. Patients who underwent transurethral prostate resection before implantation were excluded from study. Overall 79 patients (3.3%) underwent channel transurethral resection of the prostate due to urinary retention or refractory obstructive urinary symptoms. Correlation analyses were performed using the chi-square (Pearson) test. Estimates for time to urinary incontinence were determined using the Kaplan-Meier method with comparisons using logistic regression and Cox proportional hazard rates.

RESULTS

Median followup after implantation was 7.2 years. Median time to first transurethral prostate resection after implantation was 14.8 months. Of the 79 patients who underwent transurethral prostate resection after implantation 20 (25.3%) had urinary incontinence compared with 3.1% of those who underwent implantation only (OR 10.4, 95% CI 6-18, p<0.001). Of the 15 patients who required more than 1 transurethral prostate resection, urinary incontinence developed in 8 (53%) compared with 19% of patients who underwent only 1 resection (OR 4.9, 95% CI 1.5-16, p=0.006). Exclusion of patients who underwent multiple transurethral prostate resections still demonstrated significant differences (18.8% vs 3.1%, OR 7.1, 95% CI 3.6-13.9, p<0.001). Median time from last transurethral prostate resection to urinary incontinence was 24 months. On linear regression analysis, hormone use and transurethral prostate resection after implantation were associated with urinary incontinence (p<0.05). There was no correlation between the timing of transurethral prostate resection after implantation and the risk of incontinence.

CONCLUSIONS

Urinary incontinence developed in 25.3% of patients who underwent transurethral prostate resection after prostate brachytherapy. The risk of urinary incontinence correlates with the number of transurethral prostate resections. Patients should be counseled thoroughly before undergoing transurethral prostate resection after implantation.

Authors+Show Affiliations

Mount Sinai School of Medicine, New York, New York. Electronic address: stephen.mock@mountsinai.org.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23669568

Citation

Mock, Stephen, et al. "Risk of Urinary Incontinence Following Post-brachytherapy Transurethral Resection of the Prostate and Correlation With Clinical and Treatment Parameters." The Journal of Urology, vol. 190, no. 5, 2013, pp. 1805-10.
Mock S, Leapman M, Stock RG, et al. Risk of urinary incontinence following post-brachytherapy transurethral resection of the prostate and correlation with clinical and treatment parameters. J Urol. 2013;190(5):1805-10.
Mock, S., Leapman, M., Stock, R. G., Hall, S. J., & Stone, N. N. (2013). Risk of urinary incontinence following post-brachytherapy transurethral resection of the prostate and correlation with clinical and treatment parameters. The Journal of Urology, 190(5), 1805-10. https://doi.org/10.1016/j.juro.2013.05.010
Mock S, et al. Risk of Urinary Incontinence Following Post-brachytherapy Transurethral Resection of the Prostate and Correlation With Clinical and Treatment Parameters. J Urol. 2013;190(5):1805-10. PubMed PMID: 23669568.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of urinary incontinence following post-brachytherapy transurethral resection of the prostate and correlation with clinical and treatment parameters. AU - Mock,Stephen, AU - Leapman,Michael, AU - Stock,Richard G, AU - Hall,Simon J, AU - Stone,Nelson Neal, Y1 - 2013/05/10/ PY - 2013/05/06/accepted PY - 2013/5/15/entrez PY - 2013/5/15/pubmed PY - 2013/12/16/medline KW - BED KW - CT KW - EBRT KW - HT KW - I-PSS KW - International Prostate Symptom Score KW - PSA KW - QOL KW - TRUS KW - TURP KW - UI KW - biologically effective dose KW - brachytherapy KW - computerized tomography KW - external beam radiation therapy KW - hormonal therapy KW - prostate specific antigen KW - prostatic neoplasms KW - quality of life KW - transrectal ultrasound KW - transurethral prostate resection KW - transurethral resection of prostate KW - urinary incontinence SP - 1805 EP - 10 JF - The Journal of urology JO - J Urol VL - 190 IS - 5 N2 - PURPOSE: We assess the risk of urinary incontinence after transurethral prostate resection in patients previously treated with prostate brachytherapy. MATERIALS AND METHODS: A total of 2,495 patients underwent brachytherapy with or without external beam radiation therapy for the diagnosis of prostate cancer between June 1990 and December 2009. Patients who underwent transurethral prostate resection before implantation were excluded from study. Overall 79 patients (3.3%) underwent channel transurethral resection of the prostate due to urinary retention or refractory obstructive urinary symptoms. Correlation analyses were performed using the chi-square (Pearson) test. Estimates for time to urinary incontinence were determined using the Kaplan-Meier method with comparisons using logistic regression and Cox proportional hazard rates. RESULTS: Median followup after implantation was 7.2 years. Median time to first transurethral prostate resection after implantation was 14.8 months. Of the 79 patients who underwent transurethral prostate resection after implantation 20 (25.3%) had urinary incontinence compared with 3.1% of those who underwent implantation only (OR 10.4, 95% CI 6-18, p<0.001). Of the 15 patients who required more than 1 transurethral prostate resection, urinary incontinence developed in 8 (53%) compared with 19% of patients who underwent only 1 resection (OR 4.9, 95% CI 1.5-16, p=0.006). Exclusion of patients who underwent multiple transurethral prostate resections still demonstrated significant differences (18.8% vs 3.1%, OR 7.1, 95% CI 3.6-13.9, p<0.001). Median time from last transurethral prostate resection to urinary incontinence was 24 months. On linear regression analysis, hormone use and transurethral prostate resection after implantation were associated with urinary incontinence (p<0.05). There was no correlation between the timing of transurethral prostate resection after implantation and the risk of incontinence. CONCLUSIONS: Urinary incontinence developed in 25.3% of patients who underwent transurethral prostate resection after prostate brachytherapy. The risk of urinary incontinence correlates with the number of transurethral prostate resections. Patients should be counseled thoroughly before undergoing transurethral prostate resection after implantation. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/23669568/Risk_of_urinary_incontinence_following_post_brachytherapy_transurethral_resection_of_the_prostate_and_correlation_with_clinical_and_treatment_parameters_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2013.05.010?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -