How would you treat high risk prostate cancer in a patient with autonomic bladder dysfunction?
He cannot sense bladder fullness but has no incontinence. Intermittently he urinates by increasing intra-abdominal pressure resulting in a good stream. At simulation, his bladder wasn't adequately full. Four hours and a total of 90 ounces of water later yielded adequate filling. Work-up for etiology is on-going.
Answer from: Radiation Oncologist at Academic Institution
Personally, I have not treated a large number of such patients, but they've generally had this problem due to diabetes or Parkinson's disease. However, it might be prudent to wait for the workup for an etiology before starting radiation therapy. For high risk patients, you're generally considering a...
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