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Complications after prostate brachytherapy in the Medicare population
R M Benoit1, M J Naslund, J K Cohen
1Department of Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania 15222, USA.
Urology
|February 2, 2000
Summary
Prostate brachytherapy for localized prostate cancer shows low complication rates, including urinary incontinence and erectile dysfunction, according to Medicare data. Rectal complications were also consistent with published findings.
Area of Science:
- Urology
- Oncology
- Public Health
Background:
- Prostate brachytherapy is increasingly popular for localized prostate cancer.
- Nationwide data on complications following this procedure were previously limited.
Purpose of the Study:
- To report on the complications associated with prostate brachytherapy in the Medicare population.
- To provide nationwide data on outcomes after prostate brachytherapy.
Main Methods:
- Identified men in the Medicare population who underwent prostate brachytherapy in 1991.
- Analyzed inpatient, outpatient, and physician claims from 1991 to 1993 to determine outcomes and complications.
Main Results:
- Of 2124 men, 8.3% had bladder outlet obstruction surgery, 0.3% required colostomy for radiation complications, and 0.2% had artificial urinary sphincters placed.
- 6.6% were diagnosed with urinary incontinence, 8.4% with erectile dysfunction, and 5.5% with rectal injury after the procedure.
- Penile prostheses were placed in 0.6% of men within 24-36 months.
Conclusions:
- Prostate brachytherapy demonstrates a low rate of urinary incontinence, bladder outlet obstruction, and erectile dysfunction in a nationwide cohort.
- Rectal complication rates were consistent with previously published studies.
- Medicare claims data provide valuable insights but have limitations in fully assessing patient outcomes.