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Post Pelvic Radiotherapy Affectation of the Lower Urinary Tract Peripheral Innervation in Men.

Santiago Méndez-Rubio¹, Jesús Salinas Casado, Miguel Vírseda Chamorro

¹Department of Urology, Hospital Sanitas La Moraleja, Madrid, Spain.

Urologia Internationalis

|June 7, 2016

Summary

Pelvic radiotherapy (RT) causes pudendal nerve damage, leading to denervation in men, even long after treatment. Surgery is not a risk factor for these electromyography (EMG) alterations.

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Area of Science:

Urology
Neurology
Oncology

Background:

Periurethral electromyography (EMG) alterations after pelvic radiotherapy (RT) in men are not well-documented.
Limited literature exists on the long-term effects of RT on the pelvic floor muscles and nerves.

Purpose of the Study:

To compare EMG data between men who received pelvic RT and a non-irradiated control group.
To investigate the impact of RT on neuromuscular function of the periurethral muscles.

Main Methods:

Retrospective assessment of 61 men who underwent RT (27 with prior surgery) and 99 controls.
EMG performed using a concentric needle electrode, with sphincter localization via visual and auditory signals.

Main Results:

Significant EMG abnormalities observed post-RT, including denervation (14.8%) and reinnervation (62.9%).
Age, neurogenic bladder, and smaller post-RT prostate size were identified as risk factors for abnormal EMG.
Pelvic radiotherapy itself was the sole significant risk factor (p < 0.001).

Conclusions:

Pelvic RT induces lesions in the pudendal nerve, resulting in denervation detectable even in late periods.
Surgical intervention did not emerge as a risk factor for these EMG changes.