Hypothesis / aims of study
Prostate cancer’s (PC) local treatment includes radical prostatectomy and radiotherapy (RT) that has some impact on genito-urinary system despite of the important advances that had been made in techniques of RT. Some patients may have long-term urinary side effects such as increased urinary frequency, urgency, urinary incontinence and dysuria…These symptoms may impact significantly patient’s quality of life.These signs can be explained by radiation-induced complications like cystitis, ureteral and bladder fistula, urethral and ureteral stricture… (1)
The aim of this study is to evaluate the outcomes of uroflowmetry in patients who underwent radiotherapy for prostate cancer in order to highlight the impact of RT on urinary tract.
Study design, materials and methods
This was a single-center retrospective study including 33 patients who underwent radiotherapy for prostate cancer. All patients had completed radiotherapy at least 12 months before uroflowmetry evaluation to analyse the effect of late complications related to RT on voiding.
We evaluated lower urinary tract symptoms (LUTS) using Urinary Symptom Profile (USP), 3-day frequency-volume charts (FVC), uroflowmetry (UFM) and post-void residual urine volume (PVR) measurement.
Interpretation of results
Our study reported some consequences of radiotherapy for prostate cancer, divided into obstructive and/or irritating urinary symptoms, such as nocturia, urgency, dysuria, frequency and urinary incontinence. These symptoms are related to chronic radiation cystitis and urethral stenosis which are the most frequent complications of RT for prostate cancer.
Beside radiation, comorbidities like diabetes, hypertension and patient’s age, total radiation dose, chemotherapy or surgery with postoperative complications are risk factors for RT complications. Voiding dysfunction caused by urethral stricture can lead to upper urinary tract damage. (2)
The use of uroflowmetry as a non invasive test allowed to showcase dysuria using Qmax and voided volume with the measurement of post void residual urine volume.