Poster Presentation – Abstracts Archive

UK & Ireland Prostate Brachytherapy Conference 2017

Abstract number 13

Urinary and sexual functional outcomes following successful treatment of prostate cancer using Low-Dose Rate Brachytherapy

Murtagh K*; Winyard J*; Goodall P*; Elwell C*; Kunkler R*
*Northampton General Hospital

AIMS/INTRODUCTION: Low-dose rate (LDR) brachytherapy using implanted radioactive seeds is an established treatment modality for organ conﬁ ned prostate cancer. Current guidelines suggest this as an option for men with low- or favourable intermediate-risk disease. Patients selecting LDR-brachytherapy are often those suitable for active surveillance but are seeking treatment with a low risk of complication. We aimed to assess the long-term impact of LDR-brachytherapy on urinary and sexual function in our large single institution cohort.

MATERIALS/METHODS: We retrospectively reviewed urinary and sexual functional outcomes in 300 patients successfully treated with iodine-seed brachytherapy without evidence of disease recurrence between 2005 and 2015. Prior to undergoing brachytherapy each man completed
a Sexual Health Inventory for Men(SHIM) and International Prostate Symptoms Score(IPSS) questionnaire, and under took ﬂ ow-rate analysis. These were repeated at regular intervals up to
5 years. Acute complications of urinary retention and incontinence of urine were also assessed. IPSS and SHIM scores were categorised into subgroups(Mild/Moderate/Severe). Statistical analysis of outcomes was undertaken by using Chi2-test and Paired T-test for categorical and continuous variables, respectively.

RESULTS: 8.5% of patients developed acute urinary retention and 0.9% suffered incontinence of urine. Variance analysis showed a statistically signiﬁ cant difference of IPSS, ﬂ ow-rate and SHIM between pre-treatment values and outcomes at the follow-up time points. A maintained trend of improvement is observed after the 3-month follow-up time point.

CONCLUSION: Patients undergoing low-dose brachytherapy experienced deterioration in their urinary and erectile function with maximal effect at 3 months post treatment. Recovery of erectile function is observed beyond 3 months though baseline levels are not typically achieved. Recovery to pre-treatment baseline urinary function is likely to happen beyond 3 months with the improving trend maintained at long-term follow-up. LDR brachytherapy is conﬁ rmed to be well tolerated with low incidence of long-term urinary toxicity, incontinence or acute urinary retention.