Early channel transurethral resection of the prostate for patients with urinary retention after brachytherapy

• Published in: Journal of Zhejiang University. B. Science 2014-08, Vol.15 (8), p.756-760
• Main Authors: Zhang, You-yun, Zhang, Zhi-gen, Yu, Yan-lan, Chen, Yi-cheng, Ni, Kang-xin, Wang, Ming-chao, Zhao, Wei-ping, Rehman, Faisal, Wan, Shaw P., Li, Gong-hui
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biomedical and Life Sciences; Biomedicine; Brachytherapy - adverse effects; Case Report; Humans; Kallikreins - blood; Male; Prostate-Specific Antigen - blood; Prostatic Neoplasms - blood; Prostatic Neoplasms - radiotherapy; Prostatic Neoplasms - surgery; Retrospective Studies; Time Factors; Transurethral Resection of Prostate - methods; Urinary Retention - etiology; Urinary Retention - surgery
• ISSN: 1673-1581; 1862-1783
• DOI: 10.1631/jzus.B1400100

Objective It is recommended that transurethral resection of the prostate (TURP) after brachytherapy should not be performed at an early stage after implantation. Herein we report our experiences and the results of channel TURP (cTURP) within six months post-implant for patients with refractory urinary retention. Methods One hundred and ninety patients with localized prostate cancer of clinical stages T1c to T2c were treated by brachytherapy as monotherapy at our institution from February 2009 to July 2013. Nine patients who developed refractory urinary retention and underwent cTURP within six months after brachytherapy were retrospectively reviewed and analyzed. Results The median interval between prostate brachytherapy and cTURP was three months (range 1.5 to 5.0 months). There were no intraoperative or postoperative complications and no incontinence resulting from the surgery. All urinary retention was relieved per the American Brachytherapy Society urinary symptom score. With a mean follow-up time of 16 months (range 6 to 26 months) after cTURP, no patient experienced biochemical recurrence. The mean serum prostate-specific antigen (PSA) of the patients who underwent cTURP was 0.42 ng/ml (range 0.08 to 0.83 ng/ml) at the end of their follow-up. Conclusions Early cTURP was found to be safe and effective in relieving urinary retention after brachytherapy and could be performed without compromising its therapeutic efficacy.