Relationship of the International Prostate Symptom score with urinary flow studies, and catheterization rates following 125I prostate brachytherapy

Martens, Chandra; Pond, Greg; Webster, Dennis; McLean, Michael; Gillan, Caitlin; Crook, Juanita

doi:10.1016/j.brachy.2005.12.002

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Volume 5, Issue 1 , Pages 9-13, January 2006

Relationship of the International Prostate Symptom score with urinary flow studies, and catheterization rates following ¹²⁵I prostate brachytherapy

Chandra Martens
- Department of Radiation Oncology, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
Greg Pond
- Department of Biostatistics, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
Dennis Webster
- Department of Radiation Medicine, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
Michael McLean
- Department of Radiation Oncology, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
Caitlin Gillan
- Department of Radiation Medicine, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
Juanita Crook
- Department of Radiation Oncology, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
- Corresponding author. Princess Margaret Hospital, 610 University Avenue, Toronto, Canada M5G 2M9. Tel.: +1-416-946-2919; fax: +1-416-946-2111.

Received 22 August 2005; received in revised form 29 November 2005; accepted 1 December 2005.

Abstract

Purpose

Prostate cancer patients undergoing ¹²⁵I brachytherapy were reviewed. A relationship between pretreatment risk factors including International Prostate Symptom (IPS) score, urinary flow studies, and posttreatment urinary morbidity was assessed.

Methods and materials

Pretreatment IPS scores and urinary flow studies on 207 patients were reviewed. Relationship between scores and acute urinary morbidity was evaluated.

Results

Median age, 64 years; median baseline IPS score, 9; median prostate volume, 36cc. Catheterization was required in 18% of patients. Baseline IPS score and peak flow rate (PFR) varied inversely, demonstrating that PFR for patients requiring a catheter was lower than that for those not requiring catheterization. Univariate regression showed that prostate volume, prior hormone therapy, and PFR were statistically predictive of postimplant urinary retention. For every one-unit increase in PFR, the odds of catheterization decreased by 6%. Multivariate analysis demonstrated that only PFR and prostate volume were predictive of postimplant urinary retention.

Conclusions

Pretreatment IPS questionnaire and urinary flow studies assist in predicting risk of urinary morbidity and retention post-¹²⁵I brachytherapy for prostate cancer.

Keywords: Prostate brachytherapy, Urinary morbidity, Catheterization