Abstract: PD72-11
Sources of Funding: None

Introduction

Urethral strictures are scars of urethral epithelium, which can cause an obstructive voiding dysfunction with consecutive damage of the upper urinary tract. Almost 45% of all strictures are iatrogenic. Strictures occur in up to 2-9% after radical prostatectomy, but can also occur after radiotherapy for prostate cancer. This study provides 5-year data of a certified prostate-cancer-centre (PKZ) for the endpoint urethral stricture.

Methods

Between 01/2008 and 12/2012 a total of 519 men were irradiated for prostate cancer (LDR- and HDR-brachytherapy as well as external beam radiation). The entire cohort was followed-up prospectively according to a standardized protocol (stratified by type of irradiation). Short segment urethral strictures were treated by urethrotomy, recurrent and long segment stenosis with buccal mucosa urethroplasty.

Results

Overall, 18 out of 519 (3.4%) patients developed a urethral stricture post-therapeutically, which recurred in 66% of cases after the first operative treatment. The largest risk for developing a urethral stricture is attributed to the HDR-brachytherapy (8.9%). 2/82 (2,4%) patients after LDR-brachytherapy developed urethral strictures; 2/279 (0,7%) patients after external beam radiation suffered from strictures.

Conclusions

Urethral strictures after radiotherapy for prostate cancer should be diagnosed and treated in a timely fashion to prevent loss of renal function. The rate of radiogenic urethral strictures (3.4%) is equivalent to those after radical prostatectomy. Due to a high rate of recurrences, urethrotomy has a limited importance after irradiation.

Funding

None