Factors associated with the frequency of self-intermittent catheterization after prostate brachytherapy.
OBJECTIVE
Urinary obstructive symptoms are the most common side effects of transperineal interstitial permanent prostate brachytherapy (TIPPB). Self-intermittent catheterization (SIC) can be used to relieve urinary retention. This study evaluated the factors associated with the probability of a patient performing SIC after TIPPB.


METHODS
We prospectively evaluated 204 patients who underwent TIPPB at Mayo Clinic Scottsdale (MCS). All patients were taught to perform SIC before implant and were instructed to do so if they could not urinate at any time after the procedure.


RESULTS
Of the 204 patients, 22 patients (11%) received (103)Pd seeds and 182 patients (89%) received (125)I. Thirty-seven (18%) patients received external-beam radiotherapy (XRT) in addition to the TIPPB. SIC was performed by 69 (34%) of the 204 patients. Factors that were significantly associated with a lower frequency of SIC were prostate volumes < or = 34.2 cm(3) (p = 0.005), < or = 137 seeds implanted (p = 0.04), prostate-specific antigen (PSA) levels < or = 6.35 (p = 0.03), American Urological Association (AUA) score < or = 10 (p = 0.01), the use of (125)I (p = 0.03), and the addition of XRT to the implant (p = 0.02).


CONCLUSIONS
Significant associations were observed between the frequency of SIC and the number of seeds implanted, AUA scores, prostate volume, PSA levels, addition of XRT, and isotope used. Whereas the first four of these factors may be surrogates for prostate volume and obstructive symptoms in general, the last two factors are related to treatment decisions. These findings may aid in better patient selection and therapeutic decisions. Additionally, this information may provide a clearer understanding of the urinary side effects of TIBBP.
Schwartz
David J
DJ
Department of Radiation Oncology, Mayo Clinic Scottsdale, Scottsdale, AZ 85259, USA.
Schild
Steven E
SE
Wong
William W
WW
Vora
Sujay A
SA
D000704:Analysis of Variance; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D010165:Palladium / Q000627:therapeutic use; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000532:radiotherapy*; D011868:Radioisotopes / Q000627:therapeutic use; D014546:Urinary Catheterization / Q000379:methods*; D016055:Urinary Retention / Q000209:etiology / Q000628:therapy*
D007457:Iodine Radioisotopes; D011868:Radioisotopes; D010165:Palladium; D017430:Prostate-Specific Antigen