Open Access

ARTICLE

Preoperative symptoms predict continence after post-radiation transurethral resection of prostate

Allison Polland¹, Emily A. Vertosick², Daniel D. Sjoberg², Gillian L. Stearns³, Laura S. Leddy⁴, Marisa A. Kollmeier⁵, Jaspreet S. Sandhu⁴

1 MedStar Washington Hospital Center, Washington, District of Columbia, USA
2 Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
3 University of Vermont Medical Center, Burlington, Vermont, USA
4 Department of Surgery, Urology Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
5 Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
Address correspondence to Dr. Allison Polland, MedStar Washington Hospital Center, 110 Irving Street NW, Washington, DC 20010 USA

Canadian Journal of Urology 2017, 24(4), 8903-8909.

Abstract

Introduction: Lower urinary tract symptoms and retention are known complications of radiation for prostate cancer and traditionally transurethral resection of the prostate (TURP) has been avoided in these patients because of the risk of incontinence. The purpose of this study was to evaluate the incidence and predictors of post-TURP incontinence in previously radiated patients.
Materials and methods: One-hundred and eleven patients who underwent brachytherapy or external beam radiotherapy for prostate cancer with subsequent TURP performed between 1992 and 2012 at a single institution were identified. We tested for associations between post-TURP continence status and pre-TURP predictors including age, preoperative urinary symptoms and type and timing of radiation therapy.
Results: New-onset incontinence developed in 27% (95% CI 17%, 39%) of patients after first post-radiation TURP and 32% (95% CI 23%, 42%) of patients after any TURP, including repeat TURPs. Forty-three percent of patients had resolution of incontinence with first TURP (95% CI 25%, 63%); only 25% (95% CI 7%, 52%) of patients had resolution following repeat TURPs. Age was significantly associated with incontinence (OR per 10 years 2.02, 95% CI 1.10, 3.74, p = 0.024). Post-TURP incontinence was more common in men with pre-TURP urgency.
Conclusions: Rates of post-TURP incontinence were higher in men who were older or had pre-TURP urinary urgency. Assessment of preoperative symptoms would allow for better patient selection. Further research should determine whether this results in better outcomes, including decreased incidence of new onset incontinence and increase in resolution of incontinence.

---

Keywords

---