PD22-07 INCIDENCE, TIMING, AND MANAGEMENT OF URETHRAL STRICTURE FOLLOWING PRIMARY RADIATION THERAPY FOR PROSTATE CANCER

Abstract

You have accessJournal of UrologyTrauma/Reconstruction: Urethral Reconstruction (including Stricture) III1 Apr 2015PD22-07 INCIDENCE, TIMING, AND MANAGEMENT OF URETHRAL STRICTURE FOLLOWING PRIMARY RADIATION THERAPY FOR PROSTATE CANCER Timothy Baumgartner, James Ebertowski, Edith Canby-Hagino, and Steven Hudak Timothy BaumgartnerTimothy Baumgartner More articles by this author , James EbertowskiJames Ebertowski More articles by this author , Edith Canby-HaginoEdith Canby-Hagino More articles by this author , and Steven HudakSteven Hudak More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1449AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urethral stricture is a well-known complication of pelvic radiation therapy (RT) for prostate cancer, occurring in approximately 2-11% of men depending on modality of RT administered. The object of this study was to evaluate our institutional experience with urethral stricture following RT for prostate cancer. METHODS The San Antonio Military Medical Center Tumor Registry was queried to identify men who underwent primary RT for prostate cancer between the years 2000 and 2006. Inpatient and outpatient medical records were retrospectively reviewed to identify men diagnosed with urethral stricture subsequent to RT. Patients with no documented follow-up in the electronic medical record or who underwent salvage prostatectomy were excluded. Stricture treatment failure was defined as the need for intervention(s) due to stricture recurrence. RESULTS Among the 344 patients treated with RT for prostate cancer during the 7 year study period, 218 met our study inclusion criteria (median post-RT follow-up 104 months, range 50-154 months). Urethral stricture was diagnosed in 19 men (9%) a median 55 months (range 1-103 months) after completion of RT. A similar rate of urethral stricture diagnosis was seen after external beam RT (12 of 141, 9%) and brachytherapy (7 of 71, 10%, p=0.8). In 7 men, strictures were wide enough to permit passage of a 16-Fr flexible cystoscope and thus were not treated. Strictures in the remaining 12 men were treated with either dilation (n=7) or visual internal urethrotomy (VIU, n=5). Stricture treatment failed in the majority of men (7 of 12, 58%) a mean 14 months after initial treatment, and 5 patients required 2 or more additional interventions for recurrent strictures. None of the 19 men with urethral strictures due to RT underwent urethral reconstruction. CONCLUSIONS Urethral stricture is a common complication of primary RT for prostate cancer. Stricture dilation and VIU have a high failure rate and thus urethral reconstruction should be considered for appropriate operative candidates. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e478-e479 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Timothy Baumgartner More articles by this author James Ebertowski More articles by this author Edith Canby-Hagino More articles by this author Steven Hudak More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...