Urethroplasty After Radiation Therapy for Prostate Cancer
Glass AS et al. – Multiple forms of urethroplasty appear to be viable options in treating radiation–induced urethral stricture.Methods
- The authors’ urethroplasty database was reviewed for cases of urethral stricture after radiation therapy for prostate cancer between June 2004 and May 2010.
- Patient demographics, prostate cancer therapy type, stricture length and location, and type of urethroplasty were obtained.
- All patients received clinical evaluation, including imaging studies post procedure.
- Treatment success was defined as no need for repeat surgical intervention.
- Twenty–nine patients underwent urethroplasty for radiation–induced stricture.
- Previous radiation therapy included external beam radiotherapy (EBRT), radical prostatectomy (RP)/EBRT, EBRT/brachytherapy (BT) and BT alone in 11 (38%), 7 (24%), 7 (24%), and 4 (14%) patients, respectively.
- Mean age was 69 (±6.9) years. Mean stricture length was 2.6 (±1.6) cm.
- Anastomotic urethroplasty was performed in 76% patients, buccal mucosal graft in 17%, and perineal flap repair in 7%.
- Stricture was localized to bulbar urethra in 12 (41%), membranous in 12 (41%), vesicourethra in 3 (10%), and pan–urethral in 2 (7%) patients.
- Overall success rate was 90%.
- Median follow–up was 40 months (range 12–83).
- Time to recurrence ranged from 6–16 months.