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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Factors predicting for urinary morbidity following (125)iodine transperineal prostate brachytherapy.
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Factors predicting for urinary morbidity following (125)iodine transperineal prostate brachytherapy.

机译：（125）碘经会阴前列腺近距离放射治疗后预测尿毒症发病的因素。

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摘要

PURPOSE: To assess factors related to the risk of acute urinary retention and other morbidity indices in patients undergoing transperineal seed implantation of the prostate. MATERIALS AND METHODS: One hundred and seventy-three consecutive patients treated with (125)Iodine transperineal interstitial permanent prostate brachytherapy (TIPPB) were evaluated. Various demographic, pathological, symptomatic, urodynamic and dosimetric values were assessed in relation to the incidence of acute urinary retention as well as the International Prostate Symptom Score (IPSS) dynamics. Patients were routinely placed on alpha-blockade postimplant. Dosimetry was based on CT scan one month postimplant. RESULTS: Acute urinary retention developed in thirty-four patients (19.7%), at a median time of four days. Peak urinary flow rate was the only independent factor which varied significantly between those suffering retention and those not (median of 16 and 19.5ml/s respectively, P=0.005). Median preimplant IPSS was 4.0, witha median peak of 16 at 3 months. Actuarial median time to return to baseline IPSS was at 15 months. The peak IPSS above preimplant levels was correlated significantly in multivariate analysis with the number of seeds implanted superior to the physician-nominated anatomical base level of the prostate (P<0.009), as well as lower preimplant IPSS values. CONCLUSIONS: In our series, preimplant urinary flow rate was the most important factor predictive of postimplant acute urinary retention. The patients' risk of having heightened IPSS change following implantation was correlated to a lower preimplant IPSS and an increased number of seeds implanted above the level of the prostatic base, possibly reflecting bladder base rather than urethral irritation in the development of acute urinary morbidity.
机译：目的：评估经会阴种子植入前列腺的患者中与急性尿retention留风险和其他发病率指标相关的因素。材料与方法：对连续接受治疗的125例碘经经会阴间质性永久性前列腺癌近距离放射治疗（TIPPB）的患者进行了研究，共173例。根据急性尿demo留的发生率以及国际前列腺症状评分（IPSS）动态，评估了各种人口统计学，病理学，症状，尿动力学和剂量学值。患者常规接受植入后的α-受体阻滞治疗。剂量测定基于植入后一个月的CT扫描。结果：34名患者（19.7％）出现了急性尿retention留，中位时间为4天。尿流峰值速度是唯一的独立因素，在有retention留者和没有尿retention留者之间显着变化（中位数分别为16和19.5ml / s，P = 0.005）。植入前IPSS的中位数为4.0，在3个月时的中位峰值为16。恢复到基线IPSS的精算中值时间为15个月。在多变量分析中，高于植入前水平的IPSS峰值与植入的种子数量高于医师指定的前列腺解剖学基础水平（P <0.009）以及较低的植入前IPSS值显着相关。结论：在我们的系列研究中，植入前的尿流率是预测植入后急性尿retention留的最重要因素。患者植入后IPSS升高的风险与较低的植入前IPSS和植入的种子数量增加（高于前列腺基水平）有关，这可能反映了膀胱基而不是尿道刺激性的急性尿毒症。

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