Iodine-125 brachytherapy is an effective well-tolerated treatment for localized prostate cancer. Gastrointestinal complications of brachytherapy (minor rectal bleeding or tenesmus) are uncommon. Rectal ulceration or rectourethral fistulas after prostate brachytherapy are rare. We present a case of massive refractory rectal bleeding and rectourethral fistula, a complication of prostate brachytherapy never before reported. As a result of the patient's life-threatening symptoms aggressive surgical therapy was necessary.
References
1.
GreenleeRT, MurrayT, BoldenS, WingoPA.Cancer statistics, 2000.CA Cancer J Clin2000;50:7–33.
NagS, BeyerD, FriedlandJ, GrimmP, NathR.American Brachytherapy Society (ABS) recommendations for transperineal permanent brachytherapy of prostate cancer.Int J Radiat Oncol Biol Phys1999;44:789–99.
4.
StockRG, StoneNN.Permanent radioactive seed implantation in the treatment of prostate cancer.Hematol Oncol Clin North Am1999;13:489–501.
5.
HuK, WallnerK.Clinical course of rectal bleeding following I-125 prostate brachytherapy.Int J Radiat Oncol Biol Phys1998;41:263–5.
6.
JordanGH, LynchDF, WardenSS, . Major rectal complications following interstitial implantation of 125Iodine for carcinoma of the prostate.J Urol1985;134:1212–4.
7.
WallnerK, RoyJ, HarrisonL.Tumor control and morbidity following transperineal Iodine 125 implantation for stage T1/T2 prostatic carcinoma.J Clin Oncol1996;14:449–53.
