Certain signs and symptoms such as low urinary flow and urinary pain may predict a man’s risk for complications from brachytherapy for prostate adenocarcinoma, according to an article in the March issue of the Mayo Clinic Proceedings.

In the current study, 105 men treated at a single clinic were categorized as high risk (59 men, 56 percent) or low risk (46 men, 44 percent) for urinary-tract morbidity associated with therapy. After brachytherapy, 37 percent of high-risk patients developed urinary difficulties compared with 15 percent of patients classified as low risk.

Difficulties can include urine retention, the need to use a catheter to urinate, frequent urination, and pain when urinating. Researchers assessed pre-therapy factors such as severity of symptoms, urinary flow rate, residual urinary volume, and prostate volume. Using these assessments, the authors concluded they can better select patients and offer educational counseling about complications after brachytherapy.

“The results offer physicians some simple and inexpensive pretreatment testing that helps identify patients who would be at increased risk for developing urinary complications,” commented Michael Wehle, MD, lead author of the study.

In an editorial in the same issue, Igor Frank, M.D., and Michael Blute, M.D., said this study provides an important step in helping physicians inform patients about the risk of severe urinary difficulties associated with brachytherapy.

“As the number of treatment options expands, the need for evidence-based stratification tools increases,” they wrote. “Such data-based tools would enable the clinician and patient to identify treatment choices associated with the least morbidity, without altering rates of disease control, on the basis of the patient’s individual anatomical and physiological characteristics.”