Urinary Retention from Radiation Therapy

swl1956 · February 2

I'll be heading for 5 weeks of Radiation Therapy soon. Having had a bout of acute urinary retention (not being able to pee at all) after my IRE ablation procedure, I'm paranoid that it may happen again with the RT treatment. My doctor thinks it unlikely. He claims the radiation is much less likely to cause the kind of swelling of the prostate that the ablation procedure did. From what I've been reading, it sounds like I have a legitimate concern. It also appears that a prophylactic alpha blocker (flowmax) would not be effective? I would think if one were to experience urinary retention after RT the use of a catheter would be risky and painful considering the effects of radiation on the urethra. Just thinking about this gives me chills. Am I overthinking this? I'm guessing as the daily treatments progress, I might get some indication of urinary retention before it becomes acute. But what can be done seems a bit of a grey area. Anyone have any experience with this?

Clevelandguy · February 3

Hi,

Will they use the Space OR gel protection between the Prostate and bladder?

Dave 3+4

swl1956 · February 3

https://csn.cancer.org/discussion/comment/1720741#Comment_1720741

Likely not due to the ablation area may cause complications.

Steve1961 · February 4

I have radiation therapy done as my first choice of treatment. Unfortunately i didnt workout but I had an enlarged prostate. I always had urgency. After my second radiation treatment, I could not urinate at all and I mean at all nothing would come out and it was hurting really bad. Well, I immediately was put on Flomax twice a day and I had to stay on it for five years until I had my prostate removed. If I did not take the Flomax the next day, it would just barely dribble,

JackWest · February 4

https://csn.cancer.org/discussion/comment/1720741#Comment_1720741

For me, I received SpaceOAR prior to the start of radiation treatment. It is injected between the prostate and rectum to reduce radiation exposure to the rectum during the radiation treatment. Your urologist would do this while you are under anesthesia. I received it. Just ask your urologist.

centralPA · February 5

How’s your urinary issues right now? Have any?

I know from my reading that any kind of ablation procedure, whether freezing, burning, or zapping, causes big time swelling. If you aren’t having a tough time now, you should be OK. You can always hit the pause button on your treatments too.

Best of luck!

swl1956 · February 5

Thanks for the replies guys!

My Fox Chase radiation oncologist says that due to the ablated area in my prostate, SpaceOAR might be problematic and also pointed out that scheduling and performing the procedure would push back my radiotherapy by 3 or 4 weeks. She also claims that radiation rectal damage statistically occurs in only about 10% of patients. Fox Chase does offer the procedure but also lists a bunch of potentially nasty occurrences that could possibly happen (see last paragraph on below link)

https://www.foxchase.org/healthcare-professionals/physician-enewsletters/updates-urologic-oncology/summer-2019/spaceoar-hydrogel-reduces-side-effects-prostate-cancer-radiation-therapy

To answer CentralPA:

My urinary functions are fine right now. No issues at all. Yes, the IRE ablation led to much swelling in my prostate which caused a urinary retention for a few days. I would recommend anyone having an ablation to leave the foley catheter in longer to give more time for swelling to subside. I told the radiation oncologist that if I ever had to self catheterize again I would shoot myself. She offered me two options for length of Radiation Therapy; 5 weeks daily or 8 weeks daily. She said the 8 week course might offer a lesser chance of issues, but wasn't very clear. She stated that clinical trials have indicated that 5 weeks is just as effective and safe as the 8 week course. She also stated it's extremely rare that urinary retention occurs with treatment like I will be receiving, but due to my concerns recommended starting Flowmax prior to the procedure and using it throughout. I'm not sure I will however, because after speaking with her I read that Flowmax and Zytiga which I will be taking have negative interactions. As CentralPA points out, If there's any indication of a problem arising as the days progress, I can hit pause. So, I think I'll forgo the SpaceOAR and the Flowmax and keep my gun loaded.

Any opinions on 5 week vs. 8 week course?

JackWest · February 8

The SpaceOAR protects your parts from radiation damage. Why not use this proven science? My opinion from using it 3 years ago.

Old Salt · February 8

SpaceOAR is not necessarily recommended for ALL. Whereas many have benefitted, this does not mean it is appropriate for all cases. Leave it to the specialist to decide what is best for YOUR situation.

swl1956 · February 9

https://csn.cancer.org/discussion/comment/1720757#Comment_1720757

How long before your radiation was the Spaceoar injected?

swl1956 · February 9

https://csn.cancer.org/discussion/comment/1720856#Comment_1720856

Hi Old Salt,

I curious if you had Spaceoar? And if not, have you had any long term rectal or urinary issues?

JackWest · February 9

https://csn.cancer.org/discussion/comment/1720864#Comment_1720864

SWL, It was about 5-6 weeks before radiation start. The SpaceOAR was received in my urologist's office. They put me out, so I was in the chair but never felt it. It was all 3 years ago. I would do it all again. The entire team was excellent.

Old Salt · February 9

https://csn.cancer.org/discussion/comment/1720865#Comment_1720865

I had radiation therapy (SBRT + IMRT) about eleven years ago. Copilot tells me SpaceOAR became available to patients in 2016.

Yes, I did have some bleeding from the rectal area about a year after treatment. It looked worrisome, but my radiation oncologist told me it would likely go away by itself. Because I was worried, he did recommend a colonoscopy. During that procedure, several damaged sites were identified. They were treated with the Argon Plasma Coagulation procedure. No problems after that. Happy overall 😀.

I do have relatively minor urinary flow issues at night, but they could well be due to just getting older 😒. Not taking any drugs for that.

Urinary Retention from Radiation Therapy

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