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Urology/Post prostate cancer radioactive seeding complications

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Question
Dear Dr. Leslie,
My father was diagnosed with prostate cancer this past fall and elected to undergo the radioactive seeding technique under the suggestion of his doctor. Prostate surgery was not suggested because of the size of his prostate and the fear that surgery would result in potential nerve damage. Since the procedure, he has experienced a number of side effects, the main problem being the fact he cannot urinate without a catheter. He has had a catheter in since the surgery and every time it is removed he experiences severe bladder spasms and is unable to urinate on his own. He also has been experiencing reccurrent bladder infections. It's been about 4 months now since the original seeding has taken place and his doctor says that his problem is due to the inflammation from the prostate due to the seeding and that it should resolve over time. My father is currently on valium to deal with the pain but I am worried that this problem will not resolve on its own. My question for you is, from your experience how common is this complication in patients with prostate cancer and are there any other acctions that he can take in order to speed up his recovery?

Thank you

Answer
Rebecca:

While some temporary voiding problems are not uncommon, by 4 months he should be voiding on his own.  The bladder spasms should be treatable with medication.  Intermittent self catheterization is certainly possible.  (I'm assuming he has failed trials of medication aimed at helping him void like alfuzosin and flomax.)  Hormone therapy is another option as it will tend to shrink the prostate as well.  

Over time, radiation will tend to shrink the prostate so there is hope that this will resolve.  A suprapubic tube is another possible solution.  You and he should have a long talk with his urologist.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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