MP09-18 COMPARING DIFFERENT TREATMENT OPTIONS FOR BLADDER OUTLET OBSTRUCTION IN PATIENTS FOLLOWING RADIOTHERAPY FOR PROSTATE CANCER

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology II (MP09)1 Sep 2021MP09-18 COMPARING DIFFERENT TREATMENT OPTIONS FOR BLADDER OUTLET OBSTRUCTION IN PATIENTS FOLLOWING RADIOTHERAPY FOR PROSTATE CANCER Monika Tedeschi, Lauren Keenan, Gregg Eure, and Kurt McCammon Monika TedeschiMonika Tedeschi More articles by this author , Lauren KeenanLauren Keenan More articles by this author , Gregg EureGregg Eure More articles by this author , and Kurt McCammonKurt McCammon More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001982.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is no consensus on the best treatment option for bladder outlet obstruction (BOO) in patients who have received radiation therapy for prostate cancer. In this review, we look at the efficacy of prostatic urethral lifts (PULs), laser photovaporization of the prostate (PVP), and transurethral resection of the prostate (TURP) in the treatment of BOO in patients who have undergone radiotherapy. METHODS: In this retrospective review, patients with a history of radiotherapy who required a BOO procedure between October 2011 and September 2020 were investigated. Different forms of radiation included external beam radiation (EBRT), brachytherapy (BT), EBRT + BT, and proton therapy. International Prostate Symptom Scores (IPSS) and Quality of Life (QOL) scores were assessed prior to the intervention and at 6-month and 12-month post-procedure intervals. Need for additional procedures as well as adverse side effects following initial BOO procedure were assessed. RESULTS: Eighty-five patients with a history of radiation underwent treatment for BOO between October 2011 and September 2020. Twenty-five, 28, and 32 patients underwent PULs, PVP, and TURP, respectively. The average time from radiotherapy to a BOO procedure was 6.9 years. Prior to undergoing PULs, the mean IPSS and QOL scores were 21.3 and 4.7, respectively. Six-month post-procedure IPSS and QOL scores were significantly improved from pre-procedure scores (14.4 (p=0.0009) and 3.2 (p=0.003), respectively). Twelve-month post-procedure IPSS and QOL scores were also significantly improved compared to pre-procedure scores (13.4 (p=0.002) and 3.1 (p=0.008), respectively). Thirty-two percent of patients who underwent PULs required additional procedures compared to 68% of patients who underwent PVP (p=0.009). The was no significant difference between TURP and PULs in the need for additional procedures. Regardless of surgical approach, incontinence was the most common adverse event (40%, 54%, and 28% of patients undergoing PULs, PVP, and TURP, respectively). PVP had the highest rate of urethral strictures (28%). PULs had the highest rate of prostatic calcifications (16%). Of the radiation treatments, EBRT + BT had the highest rate of incontinence at 81%. CONCLUSIONS: PULs significantly improved patients’ obstructive voiding symptoms and quality of life at 6 and 12 months following the procedure. Regardless of the surgical approach, patients with BOO and a history of radiation need to be counseled on adverse side effects and the high likelihood of multiple additional procedures. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e167-e167 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Monika Tedeschi More articles by this author Lauren Keenan More articles by this author Gregg Eure More articles by this author Kurt McCammon More articles by this author Expand All Advertisement Loading ...