Can radiation therapy lead to urinary problems and further surgery in prostate cancer patients?

The authors aimed to determine signs and symptoms of urinary problems following radiation in prostate cancer patients and the need for further corrective surgery. 

Radiation therapy is a common treatment for prostate cancer. Radiation therapy involves directing a beam of radiation at the tumor site in order to kill cancer cells with minimal damage to healthy cells. Some patients may experience urinary problems following treatment. These problems may require treatments to improve urine flow. A urinary diversion is a surgical procedure that helps redirect urine flow to pass from the kidneys into a pouch located on the stomach.

The aim of this study was to determine the signs and symptoms of urinary problems following radiation treatment that led to urinary corrective surgery.

30 patients were used in this study. Each patient underwent urinary diversion following radiation therapy. The average time from radiation until urinary problems occurred was 4.6 years. 20% of patients received external beam radiation (external radiation directed at tumor cells) and 37% of patients received brachytherapy (radiation seed planted internally at the tumor site). 43% of patients received a combination of both.

37% of patients experienced random tissue growth caused by injury or previous surgery. 20% of patients experienced inflamed, painful bladders. 27% experienced loss of urinary control. 17% experienced a combination of inflamed, painful bladders and loss of urinary control. External beam radiation more often led to inflamed, painful bladders. Brachytherapy more often led to loss of urinary control. These symptoms required urinary diversion.

Patients received different types of urinary diversion. 63% of patients had their bladder surgically removed and had their urine flow redirected into a pouch located on the stomach. 17% of patients had their urine flow redirected into a pouch located on the stomach. 20% of patients had a tube inserted into the bladder via the stomach that drained urine from the bladder.

The authors concluded that radiation therapy led to symptoms including inflamed, painful bladders and decreased urinary control and function.  These urinary problems required urinary diversion. 

Patients used did not receive radiation therapy at the same institution so results may be biased. 

If you are considering radiation therapy or urinary diversion as a treatment option, please consult your doctor for potential risks and benefits.