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Transurethral resection of the prostate after radiotherapy for prostate cancer: Impact on quality of life
Author(s) -
Pinkawa Michael,
Klotz Jens,
Djukic Victoria,
Petz Dalma,
Holy Richard,
Eble Michael J
Publication year - 2014
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12460
Subject(s) - medicine , prostate cancer , transurethral resection of the prostate , urology , prostate , radiation therapy , quality of life (healthcare) , urinary system , international prostate symptom score , external beam radiotherapy , urinary retention , urinary incontinence , surgery , lower urinary tract symptoms , cancer , nursing
Objectives To evaluate the impact of transurethral resection of the prostate on quality of life after radiotherapy for prostate cancer. Methods A group of 49 consecutive patients with and 487 without prior transurethral resection of the prostate responded to the Expanded Prostate Cancer Index Composite questionnaire before, on the last day, and a median time of 2 months and 16 months after external beam radiotherapy (70–78 Gy). A matched‐pair analysis was used to avoid the influence of treatment‐associated confounding factors, including dose, treatment volume and hormonal therapy. Results Significantly smaller acute urinary score changes relative to baseline levels resulted with versus without prior transurethral resection of the prostate (mean function/bother score decrease of 3/6 vs 18/21 points at the end of radiotherapy; P < 0.01), affecting urinary incontinence (pads to control urinary leakage in 4% vs 24%; P = 0.03) and irritative/obstructive symptoms (big/moderate problem with weak urinary stream in 11% vs 37%; P = 0.02). As opposed to acute changes, transurethral resection of the prostate was a significant predisposing factor for a long‐term urinary function score decrease >10 points (20% vs 6% of patients with vs without prior resection; P = 0.04). Urinary incontinence risk was higher for patients with a longer time from resection to radiotherapy. Conclusions Transurethral resection of the prostate significantly affects acute (considerably fewer symptoms) and long‐term (relevant toxicity in some cases) urinary quality of life after radiotherapy for prostate cancer.