Dosimetric analysis of urethral strictures following HDR 192Ir brachytherapy as monotherapy for intermediate- and high-risk prostate cancer

Díez, Patricia; Mullassery, V.; Dankulchai, Pittaya; Ostler, Peter; Hughes, Robert J.; Alonzi, R.; Lowe, Gerry; Hoskin, Peter

doi:10.1016/j.radonc.2014.10.007

Cited by 15 publications

(14 citation statements)

References 31 publications

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“…Several randomized clinical trials have shown that dose-escalated RT to the prostate gland resulted in improved biochemical and local controls. However, this improvement in outcomes is often associated with increased rates of urinary toxicity [ 13 14 15 ]. Merrick et al [ 15 ] revealed in a series with low-dose rate (LDR) BT patients that urethral stricture correlates highly with the radiation dose to the membranous urethra.…”

Section: Dosimetric Analysesmentioning

confidence: 99%

Urethral strictures after radiation therapy for prostate cancer

et al. 2016

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Urethral stricture after radiation therapy for localized prostate cancer is a delicate problem as the decreased availability of tissue healing and the close relation to the sphincter complicates any surgical approach. We here review the pathophysiology, dosimetry, and the disease specific aspects of urethral strictures after radiotherapy. Moreover we discuss different treatment option such as direct vision internal urethrotomy as well as techniques for open reconstruction with and without tissue transfer.

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Section: Dosimetric Analysesmentioning

confidence: 99%

Urethral strictures after radiation therapy for prostate cancer

et al. 2016

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“…Similar to ERBT, BT strictures affect the bulbomembranous urethra in the majority of cases, which could be due to a “hot spot” in the distal bulbar urethra (23) or due to caudal needle shifting in patients receiving HDR-BT (30), although Hindson found no relation between needle shifting and stricture incidence (36). A prospective, matched-pair analysis by Diez found no association between urethral stricture incidence and urethral dosimetry in patients receiving HDR-RT, however the number of events was too small to draw a definitive conclusion (37). …”

Section: Introductionmentioning

confidence: 99%

Management of bladder neck stenosis and urethral stricture and stenosis following treatment for prostate cancer

Nicholson

Al-Hakeem

Maldonado

et al. 2017

Transl. Androl. Urol.

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The aim of this review is to examine all urethral strictures and stenoses subsequent to treatment for prostate cancer, including radical prostatectomy (RP), radiotherapy, high intensity focused ultrasound (HIFU) and cryotherapy. The overall majority respond to endoscopic treatment, including dilatation, direct visual internal urethrotomy (DVIU) or bladder neck incision (BNI). There are adjunct treatments to endoscopic management, including injections of corticosteroids and mitomycin C (MMC) and urethral stents, which remain controversial and are not currently mainstay of treatment. Recalcitrant strictures are most commonly managed with urethroplasty, while recalcitrant stenosis is relatively rare yet almost always associated with bothersome urinary incontinence, requiring bladder neck reconstruction and subsequent artificial urinary sphincter (AUS) implantation, or urinary diversion for the devastated outlet.

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“…reported the dose to the bulbomembranous urethra as a significant risk factor of urethral stricture as the present study suggested, Diez et al . reported the opposite result . However, we believe that the number of events in the latter study (just 10 patients with stricture) was not sufficient to reach statistical significance.…”

Section: Dosimetric Differences Between the Two Groupsmentioning

confidence: 62%