Post transurethral resection of prostate incontinence in previously radiated prostate cancer patients

OBJECTIVES: This is a retrospective review evaluating the incidence of incontinence post transurethral resection of prostate (TURP) in patients who have had previous external beam radiation (XRT) for prostate cancer (PCA). MATERIALS AND METHODS: 1,230 patients underwent XRT for PCA between January 1985 and April 1996. From this group, 16 patients mean age of 67.8 years (range 48-84) at the time of XRT had a subsequent TURP for obstructive symptoms a median of 3.25 years later (range 3 months to 10.2 years). Patients have been followed post TURP for a median of 5.0 months (range 1 to 81 months). RESULTS: Nineteen percent (3) patients developed incontinence post TURP. An additional patient remained in retention and continued to suffer overflow incontinence. Incontinence was associated with a shorter time interval between XRT and TURP (13 months versus 55.3 months) and with a greater amount of prostatic resection (19 grams versus 11.4 grams) when compared to the continent group, but did not meet statistical significance. CONCLUSION: A high risk of incontinence post TURP in previously radiated patients was demonstrated. The association with a shorter time interval between procedures and the larger resection suggests that a conservative approach is warranted. Studies with the use of preop and post TURP urodynamics would be useful in further defining risk factors in this population.