Two-step transurethral surgery of the prostate and permanent implant brachytherapy for patients with lower urinary tract symptoms and low- to intermediate-risk prostate cancer

High dose rate brachytherapy boost for prostate cancer: Biochemical control and the impact of transurethral resection of the prostate and hydrogel spacer insertion on toxicity outcomes

“…A prior mini TURP did not result in a urinary incontinence rate of 18% as previously reported by Kollmeier et al . The use of a prior mini TURP in LDR brachytherapy has also shown similar low GU toxicity with no urethral necrosis or urinary incontinence reported …”

“…19,20 A prior mini TURP did not result in a urinary incontinence rate of 18% as previously reported by Kollmeier et al 21 The use of a prior mini TURP in LDR brachytherapy has also shown similar low GU toxicity with no urethral necrosis or urinary incontinence reported. 22,23 The use of HS was also safe with all patients successfully implanted with no postoperative complications reported. In addition, we reported less GI rectal toxicities in patients who underwent HS insertion.…”

Iodine-125 Seed Implantation and Deferred Transurethral Resection of the Prostate for Patients With Lower Urinary Tract Symptoms and Localized Prostate Cancer

“…In recent years, some researchers tried to treat these patients with TURP or TUIP before brachytherapy and achieved relatively satisfactory results. 11 However, not all patients who are at 'high-risk' for obstruction need to have a TURP, especially in light of the complication risks. The approach of performing a TURP only in patients who finally develop obstructive symptoms after brachytherapy is more reasonable.…”

“…1,[7][8][9] Recently, a 2011 French study deemed a 1-step approach in which transurethral resection was performed immediately before brachytherapy "technically feasible but too toxic," resulting in high postbrachytherapy International Prostate Symptom Score (IPSS) and overall poor patient tolerance. 10 Also, Ivanowicz et al 11 published their clinical experience with limited TURP (LTURP) and/or TUIP months (mean, 5.7 months) before brachytherapy to treat patients with LUTS and low-to-intermediate risk PCa and came to the conclusion that the 2-step LTURP and/or TUIP more than 4 months before brachytherapy is a safe and effective treatment strategy for men with LUTS and low-to-intermediate risk PCa. However, not all patients who are at 'high-risk' for obstruction need to have a TURP, especially in light of the complication risks.…”

Brachytherapy: state‐of‐the‐art radiotherapy in prostate cancer

“…Urinary obstruction may be anatomical in nature, such as bladder neck dyssynergia, urethral strictures or prominent obstructing median lobes. If medical therapy with α‐blockers or 5‐α‐reductase inhibitors fail to improve the flow rate, then a pre‐emptive transurethral incision of prostate or limited TURP can be safely performed in these patients to improve urinary flow before brachytherapy to reduce the risk of urinary retention .…”