[Retrospective evaluation of urinary continence in patients submitted to brachytherapy after transurethral resection of the prostate gland].
OBJECTIVE
Some candidates for brachytherapy present with a previous history of prostate transurethral resection (TURP). Nonetheless, TURP generates a cavity that may lead to technical difficulties in performing brachytherapy. Such condition make a history of previous TURP a relative contra-indication for brachytherapy. The aim of this study is to evaluate the role of brachytherapy in urinary continence, in a group of patients with previous history of TURP.


METHODS
In our study, we analysed a group of 16 patients submitted to TURP pre-brachytherapy. The mean quality of life score from ICSmaleSF questionnaire ranged from 0 to 1 before and after brachytheraphy (average: 0,18 -- before; average: 0,20 -- after). There was no estatistically significant difference between the former values (p<0,001). After brachytherapy patients were evaluated for lower urinary tract symptoms. The time interval between TURP and brachytherapy ranged from 30 to 90 days (average: 60 days). Post-brachytherapy follow-up varied between 3 and 60 months (average: 30 months).


RESULTS
None of the 16 patients evaluated presented lower urinary tract symptoms nor urinary incontinence. Medical complications observed in patients were: dysuria, erectile dysfunction, scrotal ecchymosis and urinary retention. The cases of dysuria, scrotal ecchymosis and urinary retention observed were of short-duration, the last one with spontaneous resolution after 7 days of vesical catheterism. The patient presenting erectile dysfunction had a good response to oral type 5 fosfodiesterase inhibitor three times a week, after a six month period.


CONCLUSIONS
In accordance with other studies, we believe that with some strategy TURP should not be considered a relative contra-indication for brachytherapy.
Claros
Daniel Ramirez
DR
Departamento de Urología, Hospital dos Servidores do Estado do Rio de Janeiro, Brasil. daniel.ramirezclaros@gmail.com
Correia
João Antonio Pereira
JA
Ferreira
Luiz Renato Muglia
LR
Vaz
Fernando Pires
FP
D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D012189:Retrospective Studies; D020728:Transurethral Resection of Prostate; D014549:Urinary Incontinence / Q000209:etiology*