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Do Patients with Urodynamically Proven Infravesical Obstruction and Detrusor Overactivity Have a Higher Risk for Long-Term Bothersome Symptoms after Brachytherapy in Comparison to Patients Treated with Radical Prostatectomy for Localized Prostate Cancer?

Do Patients with Urodynamically Proven Infravesical Obstruction and Detrusor Overactivity Have a... Objective: Bothersome persistent urgency is often underestimated and can be early and late sequela following therapy for localized prostate cancer. Does urodynamic investigation help to detect those who are at risk? Do patients with similar urodynamic findings perform better after radical prostatectomy and thus should be advised against brachytherapy? Patients and Methods: Sixty-nine patients who received brachytherapy for clinically localized prostate cancer had had an urodynamic investigation prior to therapy. In addition, all received the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and the International Continence Society male questionnaire be-fore and 12 months after therapy. Sixty-one patients having undergone radical perineal prostatectomy were used as the control group. The decision for treatment modality was not influenced by the results of the urodynamic investigation. Results: Besides age there was no significant difference in demographic data and no significant difference in micturition problems and obstruction grades prior to treatment. Eighty-two percent of patients with an urodynamically proven obstruction developed bothersome urgency after brachytherapy and 29% patient after surgery (odds ratios = 3.3). Significantly, more patients with detrusor overactivity before therapy had urgency after brachytherapy compared to those after radical perineal prostatectomy (odds ratios = 4.6). However no urodynamic parameter or a combination of tests could be developed which would detect those at risk with a specificity and sensitivity of over 80%. Conclusion: Urodynamics can help to identify patients who have a higher risk of developing urgency after brachytherapy compared to patients with similar pre-therapeutic urodynamic findings who were treated with radical prostatectomy. However, further research is needed to pre-therapeutically define those patients who will benefit from pre-therapeutical urodynam-ic testing. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Urology Karger

Do Patients with Urodynamically Proven Infravesical Obstruction and Detrusor Overactivity Have a Higher Risk for Long-Term Bothersome Symptoms after Brachytherapy in Comparison to Patients Treated with Radical Prostatectomy for Localized Prostate Cancer?

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Publisher
Karger
Copyright
© 2008 S. Karger AG, Basel
ISSN
1661-7649
eISSN
1661-7657
DOI
10.1159/000189654
Publisher site
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Abstract

Objective: Bothersome persistent urgency is often underestimated and can be early and late sequela following therapy for localized prostate cancer. Does urodynamic investigation help to detect those who are at risk? Do patients with similar urodynamic findings perform better after radical prostatectomy and thus should be advised against brachytherapy? Patients and Methods: Sixty-nine patients who received brachytherapy for clinically localized prostate cancer had had an urodynamic investigation prior to therapy. In addition, all received the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and the International Continence Society male questionnaire be-fore and 12 months after therapy. Sixty-one patients having undergone radical perineal prostatectomy were used as the control group. The decision for treatment modality was not influenced by the results of the urodynamic investigation. Results: Besides age there was no significant difference in demographic data and no significant difference in micturition problems and obstruction grades prior to treatment. Eighty-two percent of patients with an urodynamically proven obstruction developed bothersome urgency after brachytherapy and 29% patient after surgery (odds ratios = 3.3). Significantly, more patients with detrusor overactivity before therapy had urgency after brachytherapy compared to those after radical perineal prostatectomy (odds ratios = 4.6). However no urodynamic parameter or a combination of tests could be developed which would detect those at risk with a specificity and sensitivity of over 80%. Conclusion: Urodynamics can help to identify patients who have a higher risk of developing urgency after brachytherapy compared to patients with similar pre-therapeutic urodynamic findings who were treated with radical prostatectomy. However, further research is needed to pre-therapeutically define those patients who will benefit from pre-therapeutical urodynam-ic testing.

Journal

Current Urology – Karger

Published: Jan 1, 2009

Keywords: Urinary incontinence; Prostate cancer; Prostatectomy; Brachytherapy; Urodynamic

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