Faculty Collaboration Database

Cystectomy and Urinary Diversion for the Management of a Devastated Lower Urinary Tract Following Prostatic Cryotherapy and/or Radiotherapy. WMJ 2016 Apr;115(2):70-3

Date

05/21/2016

Pubmed ID

27197339

Scopus ID

2-s2.0-84962635716 (requires institutional sign-in at Scopus site)   16 Citations

Abstract

INTRODUCTION: We investigated the outcomes and quality of life measures in men who underwent cystectomy and urinary diversion for devastating lower urinary tract toxicity after prostatic radiotherapy and/or cryotherapy for the treatment of prostate cancer.

METHODS: Records of patients who underwent cystectomy and urinary diversion for the management of a devastated lower urinary tract following prostatic radiotherapy or cryotherapy were reviewed retrospectively. A postoperative, retrospective quality of life (QOL) survey was designed specific to this patient subset and obtained by telephone interview.

RESULTS: Extirpative surgery with urinary diversion for management of a devastated lower urinary tract was performed on 15 patients with a mean age of 72 years (range 63-82). Toxicities leading to bladder removal included bladder neck contractures, prostatic necrosis, incontinence, osteomyelitis, bladder calculi, fistulae, urethral strictures, abscesses, necrotizing fasciitis, and radiation/hemorrhagic cystitis. The mean number of failed conservative, minimally invasive interventions per patients prior to cystectomy was 3.7 (range 1-12). The average time period from major complication following radiotherapy/cryotherapy to cystectomy was 29.1 months (range 5-65). The QOL survey showed all of the patients who completed the survey (n = 13) would undergo the procedure again and 11 (85%) would have undergone the procedure an average of 13.2 months sooner (range 5-36).

CONCLUSION: Toxicities secondary to prostatic radiotherapy or cryotherapy may be debilitating. Our results demonstrate that cystectomy with urinary diversion can improve QOL in patients with a devastated lower urinary tract.

Author List

Sack BS, Langenstroer P, Guralnick ML, Jacobsohn KM, O'Connor RC

Authors

Michael Guralnick MD Professor in the Urologic Surgery department at Medical College of Wisconsin
Kenneth Jacobsohn MD Professor in the Urologic Surgery department at Medical College of Wisconsin
Peter Langenstroer MD Professor in the Urologic Surgery department at Medical College of Wisconsin
Robert Corey O'Connor MD Professor in the Urologic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Cryotherapy
Cystectomy
Humans
Male
Middle Aged
Prostatic Neoplasms
Quality of Life
Radiation Injuries
Radiotherapy
Treatment Outcome
Urinary Bladder
Urinary Diversion