[Last resort surgical management of postradiation urinary cystitis after external beam radiation for prostate cancer: a monocentric analysis]. / Traitement chirurgical de dernier recours en cas de cystite radique après radiothérapie externe du cancer de la prostate : analyse monocentrique.

ABSTRACT

PURPOSE: To assess functional outcomes obtained after surgical management of post-radiation urinary incontinence after prostate cancer. PATIENTS AND METHOD: A retrospective review of the data from patients treated in our centre between September 2004 and February 2012 by surgery for vesicosphincteric injuries after prostatic external beam radiation therapy was performed. RESULTS: A total of seven men with a median age of 70 years ± 4.1 were included. Mean follow-up was 32.3 months ± 29 (3-86). All patients underwent a partial cystectomy and augmentation enterocystoplasty. The vesicocutaneous fistula rate was 33% occurring within a mean time of 18.5 days ± 2.1 (17-20). The mean length of urinary catheter and hospital stay were respectively 16 days ± 8.4 (12-35) and 18 days ± 7.8 (13-37). Five patients underwent asynchronous insertion of artificial urinary sphincter. The success rate of partial cystectomy and augmentation enterocystoplasty with asynchronous implantation of artificial urinary sphincter to treat post-radiation urinary incontinence was 71.5%. The median time between partial cystectomy and augmentation enterocystoplasty and artificial urinary sphincter implantation was 27.6months ± 26.4 (7-72). CONCLUSION: Surgical management of post-radiation urinary cystitis offers good functional outcomes albeit its morbidity is not negligible. It should be proposed only in expert surgical centres.