Urinary morbidity in brachytherapy patients with median lobe hyperplasia.
OBJECTIVE
To investigate clinical course of prostate brachytherapy patients with radiographic evidence of median lobe hyperplasia (MLH).


METHODS
Fifteen patients with median lobe hyperplasia were identified during our routine brachytherapy practice and implanted between June 1998 and March 2000, representing approximately 6% of the 245 brachytherapy patients treated during that time. Each patient was contacted at the time of this report preparation to update postimplant morbidity information, with follow-up ranging from 6 to 30 months (median: 18 months).


RESULTS
Three of the 15 patients developed acute, postimplant urinary retention. The preimplant prostate volume, dMLH, and preimplant AUA scores were similar between patients who did or did not develop prolonged urinary retention. Compared with a control group of 62 control patients treated during a similar time interval at the University of Washington, patients with MLH had significantly higher AUA scores at last follow-up. There was no correlation between the change in AUA scores at last follow-up.


CONCLUSIONS
Based on the data reported here, we consider MLH to be a weak contraindication to prostate brachytherapy. Considering that even patients with prolonged retention have gradually improved spontaneously, we do not advocate prophylactic prebrachytherapy resection of hypertrophic tissue in MLH patients.
Nguyen
Johnathan
J
School of Medicine, University of Washington, Seattle, WA, USA.
Wallner
Kent
K
Han
Ben
B
Sutlief
Steven
S
D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000532:radiotherapy*; D016055:Urinary Retention / Q000209:etiology*