Prospektive Evaluation harntraktbezogener Morbität von Patienten mit lokalbegrenztem Prostatakarzinom nach Brachytherapie im Vergleich zu Patienten nach radikaler Prostatektomie

Brachytherapy and radical prostatectomy are accepted treatment modalities for localised prostate cancer. Which treatment is chosen, depends on the physicians and patients decision. One important criterion for the decision is the incidence of urinary tract symptoms after therapy. 126 patients had an urodynamic investigation prior to therapy of clinically localised prostate cancer. 69 received brachytherapy, in form of permanent seed application (LDR), 36 received an iridium brachytherapy (HDR). 57 patients having undergone radical perineal prostatectomy are used as control group. All patients were questioned by a questionaire before and one year after therapy. The questionaire included the ICSmale questionaire wich contains questions about urinary tract symptoms. To find possible predictive urodynamic parameters for urinary tract symptoms after brachytherapy the data from the questionaires and the data from the urodynamics were analysed. Patients with obstuction before therapy (OCO>1) had a 19,20% higher chance to present lower urinary tract sympotms (LUTS) after brachytherapy than patients after surgery. Patients with detrusoroveractivities hd a 18,54% higher risk to present LUTS after brachytherapie than patients after surgery. Patients with urodynamically proven obstruction have a 8,7% higher chance for bothersome LUTS and bothersome urgency and a 7,26% higher chance for urge incontinence after brachytherapy than patients without obstruction. Further risk factors for post therapeutic urinary tract symptoms are pre-existing urinary morbidity and an increase prostate volume. In particular a previous TURP increases the risk for urinary morbiditiy after brachyhtherapy. Urinary morbidity after brachytherapy is described as a temporary symptomatology. Clinical studies show that post therapeutic urinary morbidity in a majority of cases regress to previous values before therapy within one year. Even though the small number of the explored patients in this study does not allow to make definitive statements or find an algorithm, it certainly shows that an urodynamic investigation prior to the therapy provides important information to evaluate the risks for urinary morbidity after brachytherapy. Patients with infravesical obstruction and detrusoroveractivities have a higher risk for urinary morbity after brachytherapy and could therefor possibly benefit more from radical perineal prostatectomy.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2008

Author dc:creator

• Rada, Anna

Contributors dc:contributor

• Jakse, Gerhard

• info:eu-repo/classification/ddc/610
• Prostatakrebs
• Brachytherapie
• Urodynamik
• Harninkontinenz
• Medizin
• prostate cancer
• brachytherapy
• urodynamics
• urinary morbidity

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-112951%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A50405