How do you approach definitive radiation for prostate cancer in a patient with perineal urethrostomy?

Long Answer:

I probably treat about 2 patients a year with perineal urethrostomy, usually due to recurrent penile cancer post penectomy. Keep in mind that when we treat prostate cancer, the penile urethra routinely receives ~78Gy EQD2 and with brachytherapy even higher biologically equivalent doses, and we do this safely with clinically significant stricture relatively uncommon. Penile urethra in Penile cancer routinely receives 60Gy EQD2 with EBRT, and higher biologically equivalent doses with ...