Dysuria after permanent prostate brachytherapy

Gregory S. Merck . IJROBP 2003; 55:979.

Five hundred eighty-one consecutive patients underwent brachytherapy between January 1998 and December 2001 for clinical T1c–T3a  adenocarcinoma of the prostate gland. The evaluated population consisted of the 546 patients who had completed at least two postimplant dysuria evaluations. The median patient follow-up was 26.4 months. In all patients, -blacker therapy was initiated before implantation and continued at least until the International Prostate Symptom Score (ISP) returned to baseline. The incidence of dysuria peaked at 52% 1 month after implantation. The median dysuria frequency score was 0 of 5 for all patients and 2 of 5 for those reporting dysuria. The median severity score was 0 of 10 for the entire cohort and 3 of 10 for those reporting dysuria. For the entire group, both the frequency and the severity of dysuria steadily improved with time, with near complete resolution of dysuria at 45 months. For those patients reporting dysuria, neither the frequency nor the severity revealed any durable improvement for approximately 36 months.  The isotope, supplemental external beam radiotherapy, hormonal status, minimal dose received by 90% of the prostate, and urethral dose did not predict for dysuria. After permanent prostate brachytherapy, dysuria is a relatively common event, but only rarely severe in frequency or intensity. At approximately 45 months after brachytherapy, dysuria appears to resolve in almost all patients.