Predictive factors of urinary retention following prostate brachytherapy.
OBJECTIVE
To evaluate the incidence and duration of urinary retention requiring catheterization and the factors predictive for these end points.


METHODS
Two hundred eighty-two patients treated with prostate brachytherapy alone were evaluated. Clinical and treatment-related factors examined included: age, baseline International Prostate Symptom Score (IPSS), presence of comorbidity, planning ultrasound target volume (PUTV), postimplant prostate CT scan volume, the CT:PUTV ratio, number of seeds inserted, number of needles used, use of neoadjuvant hormones, procedural physician, clinical stage, Gleason score, and pretreatment PSA. Dosimetric quality indicators were also examined.


RESULTS
Urinary obstruction after prostate brachytherapy developed in 43 (15%) patients. The median duration of catheter insertion was 21 days (mean 49, range 1-365). Univariate analysis demonstrated that presence of diabetes, preimplant volume, postimplant volume, CT:PUTV ratio, number of needles, and dosimetric parameters were predictive for catheterization. However, in multivariate analysis, only the baseline IPSS, CT:PUTV ratio, and presence of diabetes were significant independent predictive factors for catheterization.


CONCLUSIONS
Baseline IPSS was the most important predictive factor for postimplantation catheterization. The extent of postimplant edema, as reflected by the CT:PUTV ratio, predicted for need and duration of catheterization. The presence of diabetes was predictive for catheterization, but may relate to the absence of prophylactic steroids, and therefore requires further evaluation.
Bucci
Joseph
J
Department of Radiation Oncology, Vancouver Cancer Center, British Columbia Cancer Agency, 600 W 10th Avenue, Vancouver, BC, V5Z 4E6, Canada.
Morris
W James
WJ
Keyes
Mira
M
Spadinger
Ingrid
I
Sidhu
Sabeena
S
Moravan
Veronika
V
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001918:Brachytherapy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D012044:Regression Analysis; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000209:etiology* / Q000628:therapy