Complications Associated with Radiotherapy

Radiotherapy can induce side effects and complications such as telangiectasia, atrofia, depigmentation of the skin, fibrosis, meatal stenosis, and (painful) ulcerations and necrosis.

The most serious complications are meatal stenosis and persisting ulceration or necrosis. The reported incidence ranges from 8% to 45% and 0-23%, respectively. Brachytherapy which requires central planes close to the urethra is associated with a higher incidence of meatal stenosis. However, utilizing PDR after loading which allows dose optimization can reduce the urethral dose when central planes are required. Meatal stenosis is managed by meatal dilatation by the patient himself or by the urologist. Problematic meatal stenosis can be corrected by performing a meatoplasty.

Management of painful penile ulceration includes the use of regular analgesia although hyperbaric oxygen may also promote wound healing. Soft tissue necrosis is more of a problem and is reported in 23% of cases and often requires surgical amputation. The reported incidence of penectomy for complications secondary to radiotherapy varies from 0% to 5%.32,33

Limited data are available concerning functional and psychosexual outcomes of organ-preservation by radiotherapy. Opsjordsmoen et al. reported on post-therapy sexuality in 30 men.34 Patients underwent a semistructured interview and completed three self-administered questionnaires (psychosocial adjustment to severe illness (PAIS), mental symptoms (GHQ), and quality of life (EORTC QLQ C-30)). A global score of overall sexual functioning was constructed consisting of sexual interest, sexual ability, sexual satisfaction, sexual identity, partner relationship, and frequency of coitus. In 10 of 12 patients treated with radiotherapy the sexual global score was not or only slightly reduced. Eleven out of fourteen patients treated with local surgery, laser beam treatment, or partial penectomy had moderate to severe reduction of global sexual score. All four patients who had undergone total penec-tomy recorded a severely reduced sexual global score. It was remarkable that in the patients treated by irradiation physicians evaluated the patients' post-treatment sexuality, especially with regard to the ability to perform coitus, to be more impaired than was evaluated by the patients themselves.

How To Deal With Rosacea and Eczema

How To Deal With Rosacea and Eczema

Rosacea and Eczema are two skin conditions that are fairly commonly found throughout the world. Each of them is characterized by different features, and can be both discomfiting as well as result in undesirable appearance features. In a nutshell, theyre problems that many would want to deal with.

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