Acute urinary morbidity following I-125 prostate brachytherapy

Background. In Japan, iodine-125 (I-125) prostate brachytherapy has been legally approved since July 2003, and this method is becoming more popular. The purpose of the present study was to assess acute urinary morbidity within the first 6 months after I-125 prostate brachytherapy. Methods. A group of 130 consecutive patients with loca-lized prostate cancer was treated with I-125 prostate brachytherapy between September 2003 and June 2004, either alone (monotherapy; 66 patients) or in combination with external-beam radiotherapy (combined therapy; 64 patients). Urinary morbidity was evaluated using the National Cancer Institute - Common Terminology Criteria for Adverse Events, version 3.0. Results. During the follow-up, 111 patients (85.4%) developed some degree of urinary symptoms such as frequency, retention, dysuria, incontinence, or hematuria. Urinary frequency (73.1%) and retention (66.9%) were the most common, and showed no significant differences between the monotherapy group and combined therapy group (P = 0.352 and P = 0.630, respectively). Six patients (4.6%) required catheterization for urinary obstruction; the median timeto onset was 1.5 days (range, 1-192 days). Five of these 6 patients received monotherapy and the other received combined therapy. Conclusion. Manifestations of acute urinary morbidity, especially frequency and retention, are relatively common but acceptable events after I-125 prostate brachytherapy.