Early voiding dysfunction associated with prostate brachytherapy

Introduction: Transperineal prostate brachytherapy is gaining popularity as a treatment for clinically localized carcinoma of the prostate. Very littl e prospective data exists addressing the issue of complications associated with tills procedure. We present an analysis of the early voiding dysfuncti on associated with prostate brachytherapy. Materials and Methods: Forty-six consecutive patients who underwent Palladium-103 (Pd-103) seed placement f or clinically localized prostate carcinoma were evaluated prospectively for any morbidity associated with the procedure. Twenty-three patients complet ed an International Prostate Symptom Score (IPSS) questionnaire preoperativ ely. at their first postoperative visit, and at their second postoperative visit. The total IPSS, each of the seven individual components, and the "bo ther" score were evaluated separately for each visit, and statistical signi ficance was determined. Results: Urinary retention occurred in 7/46 patient s (15%). Of these, 5 were able to void spontaneously after catheter removal . One patient is maintained with a suprapubic tube. and one patient is curr ently on continuous intermittent catheterization. Baseline IPSS was 7.1 and this went to 20.0 at the first postoperative visit (p<0.001). By the secon d postoperative visit, the IPSS was 8.0. Conclusions: In our experience, pr ostate brachytherapy for localized carcinoma of the prostate is associated with a 15% catheterization rate and a significant increase in the IPSS (7.1 to 20.0). This increase in the IPSS seems to be self-limited. Patients nee d to be educated on these issues prior to prostate brachytherapy. (C) 2000 Elsevier Science Inc. All rights reserved.