Urinary incontinence following external-beam radiotherapy for clinically localized prostate cancer.

OBJECTIVES

To determine the incidence of urinary incontinence in men with prostate cancer treated with definitive external-beam radiation therapy and to analyze the impact of various patient and treatment variables on the development of urinary incontinence.

METHODS

The records of all 758 men who received definitive external-beam radiation therapy at our institution between October 1986 and December 1994 were reviewed. The development of incontinence was recorded and graded according to the Late Effects Normal Tissues/Radiation Therapy Oncology Group (LENT/RTOG) scoring system.

RESULTS

Late grade 2 or higher urinary incontinence developed in 4 of 758 patients (0.5%) (3 grade 2; 1 grade 3). The actuarial urinary incontinence rate was 1.3% at 5 years. Patients with a history of prior transurethral resection of the prostate (TURP) had higher rates of urinary incontinence than patients without prior TURP (prior TURP 3 of 132 [2%] versus 1 of 626 [0.2%]; P = 0.02).

CONCLUSIONS

Urinary incontinence following definitive external-beam radiation therapy for clinically localized prostate cancer is a rare event. Previous TURP increases the risk of incontinence, although the risk remains low. There is no evidence that higher doses to the prostate using conformal techniques are associated with an increased risk of urinary incontinence.