title: Presentation, management, and outcomes of complications following prostate cancer therapy.
abstract: OBJECTIVE
  To characterize complications of prostate cancer therapy and operative management in patients referred to our institution for surgical intervention.
  
  
  METHODS
  Data was abstracted from a retrospectively collected single surgeon database at a large tertiary care referral-based medical center. Variables included age, prostate cancer therapy, complication(s) and their management, and number of operations. Descriptive statistics were used.
  
  
  RESULTS
  From 2006-2010, 890 patients underwent genitourinary surgery, of which 139 were to treat complications arising from prostate cancer therapy. Complications stemmed from radical prostatectomy (RP) monotherapy, RP and external beam radiation therapy (EBRT) or brachytherapy (BT), EBRT only, BT only, and combination EBRT and BT. Complications included urinary incontinence (UI), urethral strictures, bladder neck contractures, and fistulas. UI and bladder neck contractures were more common in patients treated with RP or RP with EBRT or BT. Strictures and fistulas were common in patients treated with EBRT or BT. Interventions included direct vision internal urethrotomy, artificial urinary sphincter, urethral reconstruction, UroLume urethral stent, urethral sling, repair of fistulas, and balloon dilation. Forty eight percent of patients required multiple operations. The median number of interventions was two.
  
  
  CONCLUSIONS
  We operatively managed patients treated with non-surgical and surgical modalities for prostate cancer. Complications included UI, fistulas, strictures, and bladder neck contractures. These were managed with a variety of operative interventions. As more men undergo treatment for localized disease, more will inevitably have complications stemming from interventions.
authors.affiliation: Department of Urology, University of California, San Francisco, San Francisco General Hospital, San Francisco, CA 94117, USA.
authors.forename: Uwais B
authors.initials: UB
authors.lastname: Zaid
authors.affiliation: Department of Urology, University of California, San Francisco, San Francisco General Hospital, San Francisco, CA 94117, USA.
authors.forename: Jack W
authors.initials: JW
authors.lastname: McAninch
authors.affiliation: Department of Urology, University of California, San Francisco, San Francisco General Hospital, San Francisco, CA 94117, USA.
authors.forename: Allison S
authors.initials: AS
authors.lastname: Glass
authors.affiliation: Department of Urology, University of California, San Francisco, San Francisco General Hospital, San Francisco, CA 94117, USA.
authors.forename: Nadya M
authors.initials: NM
authors.lastname: Cinman
authors.affiliation: Department of Urology, University of California, San Francisco, San Francisco General Hospital, San Francisco, CA 94117, USA.
authors.forename: Benjamin N
authors.initials: BN
authors.lastname: Breyer
keywords: Urethral stricture; fistula; prostate cancer; urethroplasty
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