Chronic effects of therapeutic irradiation for localized prostatic carcinoma on anorectal function.

Abstract Purpose: To evaluate prospectively the prevalence and pathophysiology of anorectal dysfunction following radiation therapy (RTH) for localized carcinoma of the prostate. Methods and Materials: The following parameters of anorectal function were evaluated in each of 35 patients (aged 55–82 years) with localized prostatic carcinoma treated with RTH either to a dose of 55 Gy/20 fractions/4 weeks (18 patients) or 64 Gy/32 fractions/6.5 weeks (17 patients), before RTH and 4–6 weeks and at a mean (± SD) of 1.4 (± 0.2) years after its completion: ( 1 ) anorectal symptoms (questionnaire), ( 2 ) anorectal pressures at rest and in response to voluntary squeeze and increases in intra-abdominal pressure (multiport anorectal manometry), ( 3 ) rectal sensation (balloon distension) and ( 4 ) anal sphincteric morphology (endoanal ultrasound). Results: All but 1 patient completed three series of measurements. RTH had no effect on anal sphincteric morphology. The increase in frequency of defecation and fecal urgency and incontinence scores previously reported in the patients 4–6 weeks after RTH were sustained 1 year later ( p p p p p 1 ) frequency of defecation at 4–6 weeks and ( 2 ) rectal volumes at baseline both for ( a ) perception ( p b ) desire to defecate ( p Conclusions: Anorectal symptoms following RTH for prostatic carcinoma are common and persist at least until 1 year after its completion and are associated with objective evidence of heightened rectal sensitivity.