Complications after cystectomy and urinary diversion in patients previously treated for localized prostate cancer. Urology 2005 Oct;66(4):824-9
Date
10/19/2005Pubmed ID
16230146DOI
10.1016/j.urology.2005.04.046Scopus ID
2-s2.0-26644466117 (requires institutional sign-in at Scopus site) 30 CitationsAbstract
OBJECTIVES: To assess the morbidity associated with radical cystectomy in patients who had previously undergone definitive treatment of prostate cancer.
METHODS: A retrospective review was undertaken, identifying 35 patients undergoing radical cystectomy with a previous history of radical prostatectomy and/or radiotherapy for prostate cancer. The clinical and surgical information was analyzed to assess patient outcomes. Specific attention was given to the rate, severity, and time course of the postoperative complications. In addition, outcomes after orthotopic and continent cutaneous diversion in this patient cohort were examined.
RESULTS: An overall complication rate of 76% was seen in this patient cohort, with 47% of patients experiencing a complication that presented later than postoperative day 30. Radiotherapy was associated with a slightly greater complication rate compared with radical prostatectomy monotherapy (77% versus 71%). Continent urinary diversion (n = 14) was associated with increased morbidity compared with ileal conduit diversion (n = 21). However, a greater percentage of the complications occurring in patients undergoing ileal conduit diversion were major (80% versus 67%).
CONCLUSIONS: Our experience has suggested that radical cystectomy in patients previously treated for prostate cancer with radiotherapy and/or radical prostatectomy may be associated with a greater level of morbidity than previously reported. This finding may be, in part, because a significant portion of complications present in a delayed fashion and, as such, have not been seen in previous reports with limited follow-up. For this reason, careful consideration of these risks is necessary when counseling this patient cohort regarding the decision to undergo radical cystectomy.
Author List
Tolhurst SR, Rapp DE, O'Connor RC, Lyon MB, Orvieto MA, Steinberg GDAuthor
Robert Corey O'Connor MD Professor in the Urologic Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Cystectomy
Humans
Male
Middle Aged
Postoperative Complications
Prostatic Neoplasms
Retrospective Studies
Urinary Diversion
