Hematuria is common following post-prostatectomy radiotherapy, particularly among patients with medication allergies and those on anticoagulation/antiplatelet therapy, according to a study published in the Journal of Urology.

“Hematuria following post-prostatectomy radiotherapy is inadequately characterized,” wrote William Tyler Turchan, MD, Department of Radiation and Cellular Oncology, University of Chicago, Illinois, and colleagues, who conducted this cohort study with aims to characterize this complication including its impact on patient-reported outcomes.

The study identified patients with ≥4 years of potential follow-up following post-prostatectomy radiotherapy. Kaplan-Meier method was used to estimate freedom from grade ≥2 hematuria. Log-rank tests and the Cox model were used to assess predictors of grade ≥2 hematuria.

Patient-reported quality of life was recorded using the 26-question Expanded Prostate Cancer Index Composite (EPIC-26). Mixed-effects regression compared urinary quality of life for patients with and without hematuria.

A total of 216 men who received post-prostatectomy radiotherapy between 2007 and 2016 at a median of 20 months following prostatectomy were identified. The median follow-up was 72 months. Overall, 85 patients developed hematuria, of whom 46 (58%) underwent cystoscopy, 13 (15%) required intervention, and 26 (31%) experience recurrent hematuria.

The 8-year FFGH2 was 55% and G2H was highest in patients who received anticoagulation and/or antiplatelet therapy (hazard ratio [HR], 3.24; P <.001), those with bladder V65 Gy ≥43% (HR, 1.97; P = .004), and those with medication allergies (HR, 0.49; P = .098). Dr Turchan and colleagues noted that older age and (HR, 0.81, P = .374) and diabetes mellitus (HR, 0.49, P = .098) were not associated with G2H.

Findings from mixed-effects regression showed no clinically important difference in changes in urinary continence and irritation and/or obstruction domain scores for patients with or without hematuria.

“Hematuria following [post-prostatectomy radiotherapy] is common, especially among men with medication allergies and those on anticoagulation/antiplatelet therapy; however, [post-prostatectomy radiotherapy]-related hematuria is typically self-limited,” concluded Dr Turchan and colleagues.

“Limiting bladder V65 Gy may reduce [post-prostatectomy radiotherapy]-related hematuria,” they added.

Source:

Turchan WT, Cutright D, Wu T, et al. The effect of screening on melanoma incidence and biopsy rates. J Urol. 2022 Jun;207(6):1236-1245. doi:10.1097/JU.0000000000002443.