H. Patel et al., RISK OF INCONTINENCE WITH TRANSURETHRAL RESECTION OF THE PROSTATE AFTER RADIATION-THERAPY FOR PROSTATE-CANCER, Journal of surgical oncology, 64(2), 1997, pp. 127-129
Background: It has been reported that transurethral resection of the p
rostate (TURF) after definitive radiation therapy for prostate cancer
is associated with a significant risk of incontinence. The presumed re
ason for incontinence is external sphincter damage from TURF or pre-ex
isting damage from either extension of prostate cancer or radiation th
erapy. Methods: We reviewed seven recent cases of TURF for bladder out
let obstruction in patients who had undergone radiation therapy for cl
inical stage T(3-4)M(0)N(0) adenocarcinoma of the prostate. All seven
men progressed to either chronic retention or debilitating obstructive
symptoms with weak peak flows from 3.4 to 5.1 cc/s (mean 4 cc/s). Eac
h of them subsequently underwent a limited TURF. Results: Voiding symp
toms were reduced in all patients and peak flows were improved to 6.3
to 20 cc/s (mean 14.8 cc/s) with mean follow-up 35 m. No patient devel
oped stress urinary incontinence postoperatively. Conclusion: These re
sults suggest that TURF can be performed successfully after radiation
therapy with minimal risk of stress incontinence. (C) 1997 Wiley-Liss,
Inc.