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Photoselective Vaporesection of the Prostate via an End-firing Lithium Triborate Crystal Laser
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Haematuria after prostate brachytherapy.

Michael S Leapman1, Simon J Hall, Nelson N Stone

  • 1Department of Urology, Mount Sinai School of Medicine, New York, NY, USA. mleapman@gmail.com

BJU International
|January 31, 2013
PubMed
Summary

Gross haematuria occurred in 8.9% of men after prostate brachytherapy, often with a significant delay. Larger prostate size, external beam radiation, and freedom from biochemical failure are key risk factors.

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Area of Science:

  • Urology
  • Radiation Oncology
  • Oncology

Background:

  • Prostate brachytherapy is a common treatment for localized prostate cancer.
  • Understanding late side effects like gross haematuria is crucial for patient management.

Purpose of the Study:

  • To determine the incidence and clinical timeline of gross haematuria following prostate brachytherapy.
  • To identify patient and treatment-related risk factors for developing gross haematuria.

Main Methods:

  • Prospective collection of haematuria outcomes from 2454 patients treated with transperineal prostate brachytherapy over 20 years.
  • Analysis of associations between haematuria and various clinical, dosimetric, and treatment variables.

Main Results:

  • Gross haematuria was reported by 8.9% of patients at a median of 772.2 days post-implantation.
  • Significant risk factors included larger prostate volume (>40 cm³), use of external beam radiation, Gleason score >7, Asian ethnicity, biologically effective dose (BED) >200 Gy, and freedom from biochemical failure.
  • Multivariate analysis confirmed prostate volume, external beam radiation, and freedom from biochemical failure as independent predictors.

Conclusions:

  • Late-onset gross haematuria is a potential complication of prostate brachytherapy, occurring months to years after treatment.
  • Predictors for developing haematuria include larger prostate glands, concurrent external beam radiation, and successful cancer control (freedom from biochemical failure).