IMPACT OF MODERATE DOSE OF POSTOPERATIVE RADIATION ON URINARY CONTINENCE AND POTENCY IN PATIENTS WITH PROSTATE-CANCER TREATED WITH NERVE SPARING PROSTATECTOMY

Purpose: We analyzed the impact on potency and urinary continence of m oderate doses of radiation (45 to 54 Gy.) given postoperatively after nerve sparing prostatectomy. Materials and Methods: Between 1983 and 1 992, 294 of 762 prostate cancer patients were selected to undergo nerv e sparing prostatectomy. Subjective patient reports regarding potency and urinary continence status were obtained preoperatively, 1 year pos toperatively or 1 year after completion of radiation. Results: Of the 294 patients 105 received postoperative radiotherapy (45 to 54 Gy.) to the prostatic bed. There were patients with more advanced stages of d isease in the irradiated group, including 89% with stages C and D1 (pT 3NO and pT1 to 3, N1 to 3), compared to 14% with stages C and D1 (pT3N O and pT1 to 3, N1 to 3) in the nonirradiated group (p <0.001). No dif ference in urinary continence was noted in the irradiated (94%) compar ed to the nonirradiated group (92%, p = 0.64). Of the patients who und erwent bilateral nerve sparing prostatectomy 44% who received and 48% who did not receive radiation had recovered potency at 1 year (p = 0.7 6). Of those who underwent unilateral nerve sparing prostatectomy 10% who received and 33% who did not receive radiation had recovered poten cy at 1 year (p = 0.14). Using multivariate analysis patient age young er than 63 years and bilateral versus unilateral nerve sparing procedu res were significant predictors of potency. Conclusions: Our retrospec tive study suggests that at 1 year after treatment moderate doses of p ostoperative radiotherapy did not have a significant impact on the rec overy of urinary continence and potency after nerve sparing prostatect omy. However, longer followup is required to determine the impact of t his radiation protocol on long-term preservation of potency after nerv e sparing prostatectomy.