Purpose: Early reports of prostate brachytherapy using 2D planning and homogenous seed loading technique were significant for an increased incidence of urinary incontinence (UI) in patients with previous TURP. This study examines the incidence of urinary incontinence after radioactive seed implantation in patients with prior TURP who underwent 3D pretreatment planning and a modified peripheral loading technique.Materials and Methods: 1959 patients underwent permanent I125/Pd103 prostate brachytherapy as primary or boost treatment for adenocarcinoma of the prostate at a single institution. 152 (7.8%) patients had a TURP prior to brachytherapy. Preplanning philosophy was to place seeds >5mm from the TURP defect as outlined on the US volume study, to limit dose to TURP to <140% of prescribed dose, and to use modified peripheral loading. 120 patients were available for telephone questionnaire by the treating physician. Time from TURP to implant ranged from 1 to 312 months with a median of 72 months. Age ranged from 60 to 84 years with a median of 75 years. AUA symptom score ranged from 0 to 26 with a median of 6. 1 patient was excluded secondary to incontinence prior to implant. Median follow up is 16 months. Patients were questioned as to the presence of any leakage (UI). If there was any UI, it was then identified as either stress incontinence, urge incontinence, or both.Results: Refer to Table 1.Conclusion: We believe that prostate brachytherapy using 3D preplanning and modified peripheral loading technique can be performed safely in patients who have had previous TURP. Early follow up shows a crude incontinence rate of 11/119 (9.2%). If a stricter definition of incontinence - incontinence requiring >1 pad per day is used, the crude incontinence rate is 4/119 (3.4%). Tabled 1Time of Follow-Up Call from ImplantStress IncontinenceUrge IncontinenceBoth<6 months1/181/180/186-12 months2/250/250/25>12 months2/761/764/76 Open table in a new tab Purpose: Early reports of prostate brachytherapy using 2D planning and homogenous seed loading technique were significant for an increased incidence of urinary incontinence (UI) in patients with previous TURP. This study examines the incidence of urinary incontinence after radioactive seed implantation in patients with prior TURP who underwent 3D pretreatment planning and a modified peripheral loading technique. Materials and Methods: 1959 patients underwent permanent I125/Pd103 prostate brachytherapy as primary or boost treatment for adenocarcinoma of the prostate at a single institution. 152 (7.8%) patients had a TURP prior to brachytherapy. Preplanning philosophy was to place seeds >5mm from the TURP defect as outlined on the US volume study, to limit dose to TURP to <140% of prescribed dose, and to use modified peripheral loading. 120 patients were available for telephone questionnaire by the treating physician. Time from TURP to implant ranged from 1 to 312 months with a median of 72 months. Age ranged from 60 to 84 years with a median of 75 years. AUA symptom score ranged from 0 to 26 with a median of 6. 1 patient was excluded secondary to incontinence prior to implant. Median follow up is 16 months. Patients were questioned as to the presence of any leakage (UI). If there was any UI, it was then identified as either stress incontinence, urge incontinence, or both. Results: Refer to Table 1. Conclusion: We believe that prostate brachytherapy using 3D preplanning and modified peripheral loading technique can be performed safely in patients who have had previous TURP. Early follow up shows a crude incontinence rate of 11/119 (9.2%). If a stricter definition of incontinence - incontinence requiring >1 pad per day is used, the crude incontinence rate is 4/119 (3.4%). Tabled 1Time of Follow-Up Call from ImplantStress IncontinenceUrge IncontinenceBoth<6 months1/181/180/186-12 months2/250/250/25>12 months2/761/764/76 Open table in a new tab