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Outcomes and Complications After Intervention for Postradiation Prostatic Urethral Stenosis
Shannon M Smith1, Justin S Han1
1Department of Urology, Northwell Health, Lake Success, NY.
Urology
|February 1, 2020
Summary
Surgical intervention for postradiation prostatic urethral stenosis shows varied outcomes. Urethroplasty offers a durable solution for short strictures, while endoscopic management can stabilize patients.
Area of Science:
- Urology
- Oncology
Background:
- Postradiation prostatic urethral stenosis is a rare but challenging complication following prostate cancer radiotherapy.
- Management of this condition often requires complex interventions due to prior treatments.
Purpose of the Study:
- To evaluate treatment outcomes for patients with postradiation prostatic urethral stenosis.
- To compare the efficacy of different surgical interventions for this specific condition.
Main Methods:
- Retrospective chart review of patients diagnosed with prostatic urethral stenosis (ICD-10 code N42.89) between July 2014 and June 2018.
- Inclusion criteria required at least 3 months of follow-up and a postradiation etiology; 16 patients were analyzed with an average follow-up of 2.6 years.
Main Results:
- Urethroplasty (2 patients) resulted in no recurrent stenosis, while endoscopic management (incision/dilation) was used for others.
- Transurethral resection of the prostate was the most common initial intervention (11 patients).
- Five patients experienced severe incontinence requiring artificial urinary sphincter placement.
Conclusions:
- Urethroplasty is a feasible and effective option for short prostatic apical strictures secondary to radiation.
- Endoscopic management can provide stabilization for some patients with postradiation urethral stenosis.
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