Treatment of Urethral Strictures from Irradiation and Other Nonsurgical Forms of Pelvic Cancer Treatment
Radiation therapy (RT), external beam radiation therapy (EBRT), brachytherapy (BT), photon beam therapy (PBT), high intensity focused ultrasound (HIFU), and cryotherapy are noninvasive treatment options for pelvic malignancies and prostate cancer. Though effective in treating cancer, urethral strict...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Advances in Urology |
| Online Access: | http://dx.doi.org/10.1155/2015/476390 |
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| author | Iyad Khourdaji Jacob Parke Avinash Chennamsetty Frank Burks |
| author_facet | Iyad Khourdaji Jacob Parke Avinash Chennamsetty Frank Burks |
| author_sort | Iyad Khourdaji |
| collection | DOAJ |
| description | Radiation therapy (RT), external beam radiation therapy (EBRT), brachytherapy (BT), photon beam therapy (PBT), high intensity focused ultrasound (HIFU), and cryotherapy are noninvasive treatment options for pelvic malignancies and prostate cancer. Though effective in treating cancer, urethral stricture disease is an underrecognized and poorly reported sequela of these treatment modalities. Studies estimate the incidence of stricture from BT to be 1.8%, EBRT 1.7%, combined EBRT and BT 5.2%, and cryotherapy 2.5%. Radiation effects on the genitourinary system can manifest early or months to years after treatment with the onus being on the clinician to investigate and rule-out stricture disease as an underlying etiology for lower urinary tract symptoms. Obliterative endarteritis resulting in ischemia and fibrosis of the irradiated tissue complicates treatment strategies, which include urethral dilation, direct-vision internal urethrotomy (DVIU), urethral stents, and urethroplasty. Failure rates for dilation and DVIU are exceedingly high with several studies indicating that urethroplasty is the most definitive and durable treatment modality for patients with radiation-induced stricture disease. However, a detailed discussion should be offered regarding development or worsening of incontinence after treatment with urethroplasty. Further studies are required to assess the nature and treatment of cryotherapy and HIFU-induced strictures. |
| format | Article |
| id | doaj-art-e84f15d7c54e4faaa5567c1ec9cfba1c |
| institution | Kabale University |
| issn | 1687-6369 1687-6377 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Urology |
| spelling | doaj-art-e84f15d7c54e4faaa5567c1ec9cfba1c2025-02-03T01:03:19ZengWileyAdvances in Urology1687-63691687-63772015-01-01201510.1155/2015/476390476390Treatment of Urethral Strictures from Irradiation and Other Nonsurgical Forms of Pelvic Cancer TreatmentIyad Khourdaji0Jacob Parke1Avinash Chennamsetty2Frank Burks3Beaumont Health System, Department of Urology, 3601 W. Thirteen Mile Road, Royal Oak, MI 48073, USABeaumont Health System, Department of Urology, 3601 W. Thirteen Mile Road, Royal Oak, MI 48073, USABeaumont Health System, Department of Urology, 3601 W. Thirteen Mile Road, Royal Oak, MI 48073, USABeaumont Health System, Department of Urology, 3601 W. Thirteen Mile Road, Royal Oak, MI 48073, USARadiation therapy (RT), external beam radiation therapy (EBRT), brachytherapy (BT), photon beam therapy (PBT), high intensity focused ultrasound (HIFU), and cryotherapy are noninvasive treatment options for pelvic malignancies and prostate cancer. Though effective in treating cancer, urethral stricture disease is an underrecognized and poorly reported sequela of these treatment modalities. Studies estimate the incidence of stricture from BT to be 1.8%, EBRT 1.7%, combined EBRT and BT 5.2%, and cryotherapy 2.5%. Radiation effects on the genitourinary system can manifest early or months to years after treatment with the onus being on the clinician to investigate and rule-out stricture disease as an underlying etiology for lower urinary tract symptoms. Obliterative endarteritis resulting in ischemia and fibrosis of the irradiated tissue complicates treatment strategies, which include urethral dilation, direct-vision internal urethrotomy (DVIU), urethral stents, and urethroplasty. Failure rates for dilation and DVIU are exceedingly high with several studies indicating that urethroplasty is the most definitive and durable treatment modality for patients with radiation-induced stricture disease. However, a detailed discussion should be offered regarding development or worsening of incontinence after treatment with urethroplasty. Further studies are required to assess the nature and treatment of cryotherapy and HIFU-induced strictures.http://dx.doi.org/10.1155/2015/476390 |
| spellingShingle | Iyad Khourdaji Jacob Parke Avinash Chennamsetty Frank Burks Treatment of Urethral Strictures from Irradiation and Other Nonsurgical Forms of Pelvic Cancer Treatment Advances in Urology |
| title | Treatment of Urethral Strictures from Irradiation and Other Nonsurgical Forms of Pelvic Cancer Treatment |
| title_full | Treatment of Urethral Strictures from Irradiation and Other Nonsurgical Forms of Pelvic Cancer Treatment |
| title_fullStr | Treatment of Urethral Strictures from Irradiation and Other Nonsurgical Forms of Pelvic Cancer Treatment |
| title_full_unstemmed | Treatment of Urethral Strictures from Irradiation and Other Nonsurgical Forms of Pelvic Cancer Treatment |
| title_short | Treatment of Urethral Strictures from Irradiation and Other Nonsurgical Forms of Pelvic Cancer Treatment |
| title_sort | treatment of urethral strictures from irradiation and other nonsurgical forms of pelvic cancer treatment |
| url | http://dx.doi.org/10.1155/2015/476390 |
| work_keys_str_mv | AT iyadkhourdaji treatmentofurethralstricturesfromirradiationandothernonsurgicalformsofpelviccancertreatment AT jacobparke treatmentofurethralstricturesfromirradiationandothernonsurgicalformsofpelviccancertreatment AT avinashchennamsetty treatmentofurethralstricturesfromirradiationandothernonsurgicalformsofpelviccancertreatment AT frankburks treatmentofurethralstricturesfromirradiationandothernonsurgicalformsofpelviccancertreatment |