title: Patients' perspectives on fecal incontinence after brachytherapy for localized prostate cancer.
abstract: BACKGROUND
  When a patient is deciding between treatment options for localized prostate cancer, brachytherapy is commonly chosen for its perceived low complication profile. Brachytherapy can frequently be complicated by the development of fecal incontinence. The potential long-term impact of this dysfunction on a patient's life should be discussed.
  
  
  OBJECTIVE
  This study aimed to assess the long-term impact of brachytherapy for localized prostate cancer on fecal incontinence and to determine the impact and severity of the incontinence on patients' ability to engage in activities of daily living.
  
  
  METHODS
  A retrospective observational study was performed. A questionnaire packet was mailed to patients who had received brachytherapy treatment for localized prostate cancer and were now more than 2 years out from initial seed implantation. Each packet contained the Colon and Ano-Rectal Impact Questionnaire (assessing quality of life), the Colon and Ano-Rectal Distress Inventory, and the Cleveland Clinic Fecal Incontinence Score (both measured existence and severity of fecal incontinence).
  
  
  METHODS
  This study was conducted at Caritas Christi St. Elizabeth's Medical Center, a tertiary referral center in Boston, Massachusetts from January 1, 1998 to December 31, 2007.
  
  
  METHODS
  One hundred forty-three of 568 patients (a 25% response rate) responded and were analyzed.
  
  
  METHODS
  No interventions were performed.
  
  
  METHODS
  The main outcome was impact of fecal incontinence on quality of life.
  
  
  RESULTS
  : Of the responses to the Colon and Ano-Rectal Impact Questionnaire, 13.2% (19 patients) (P < .001) stated that fecal incontinence was impacting their ability to participate in their daily activities. Sixty-three percent (12 patients) (P < .001) of patients described the impact of the incontinence as slight, 21% (4 patients) (P < .001) described it as moderate, and 15.8% (3 patients) (P < .001) described it as severe.
  
  
  CONCLUSIONS
  There were no case-matched controls and the response rate to the surveys was low.
  
  
  CONCLUSIONS
  Postbrachytherapy fecal incontinence leaves a long-term impact on patients' ability to engage in activities of daily living.
authors.affiliation: Division of General Surgery, Caritas St. Elizabeth's Medical Center, Boston, Massachusetts 02135, USA. M.Nicole.Lamb@caritaschristi.org
authors.forename: M Nicole
authors.initials: MN
authors.lastname: Lamb
authors.forename: Lucrecia
authors.initials: L
authors.lastname: Trabinino
authors.forename: Alan
authors.initials: A
authors.lastname: Hackford
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects*; D005242:Fecal Incontinence / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires