title: The impact of acute urinary morbidity on late urinary function after permanent prostate brachytherapy.
abstract: OBJECTIVE
  Acute prostate brachytherapy-related morbidity is dominated by urinary symptomatology. In this study, we evaluated the effect of severe early brachytherapy-related urinary morbidity on late urinary function.
  
  
  METHODS
  From January 1998 to September 2003, 1029 patients were implanted for clinical stage T1b-T3a (2002 American Joint Committee on Cancer [AJCC] criteria) prostate cancer. Five hundred sixteen (50.1%) received supplemental external beam radiation therapy and 440 (42.8%) received androgen deprivation therapy. Severe acute urinary morbidity (SAUM) was defined as a dysuria frequency score of at least 4 (of 5), a dysuria severity score of at least 8 (of 10), an internation prostate symptom score (IPSS) elevated to at least 30 or 15 above preimplant value for 4 weeks, and/or requirement of a urinary catheter for at least 5 days. Dysuria severity and frequency resolution were defined as a return to within one point of baseline. IPSS resolution was defined as a return to within two points of baseline.
  
  
  RESULTS
  Of the 1029 patients, 175 met at least one of the criteria for inclusion. Dysuria frequency resolved in 5.0 vs. 1.3 weeks and dysuria severity in 5.7 vs. 1.4 weeks, for patients with and without SAUM. The mean time for IPSS resolution was 13.8 vs. 6.6 weeks, for patients with and without SAUM. The incidence of transurethral resection (2.3% [4/173] vs. 1.5% [13/841]) and bulbomembranous urethral strictures (2.2% [4/175] vs. 1.8% [15/854]) were comparable among patients with and without SAUM.
  
  
  CONCLUSIONS
  Patients experiencing brachytherapy-related SAUM have long-term urinary function and complications comparable to patients who did not develop SAUM.
authors.affiliation: Department of Radiation Oncology, University of Washington, Seattle, WA, USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Bittner
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Merrick
authors.forename: Kent E
authors.initials: KE
authors.lastname: Wallner
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Lief
authors.forename: Wayne M
authors.initials: WM
authors.lastname: Butler
authors.forename: Robert W
authors.initials: RW
authors.lastname: Galbreath
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use; D001918:Brachytherapy / Q000009:adverse effects*; D053159:Dysuria / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011467:Prostate / Q000000981:diagnostic imaging*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D011859:Radiography; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000726:Androgen Antagonists