Urinary Retention after Prostate Radiation

@bens1 Did you mean to say built-in MRI? I had my 2nd of 5 treatments yesterday, with an MRI-guided Elekta machine.

@vircet yes, thank you. Built in MRI.

Did that Elekta have auto shutoff if the radiation got outside of the mapping? Where did you get treated?

@bens1 According to literature, Elekta machines have auto shut off. There is the Elekta MR-Linac (there are very few of them in Ontario-& Quebec-Canada, compared to the older generation Elektas) but I was told that it's used only for patient's with high risks of healthy organ damage (e.g., prostate cancer patients who cannot have the gold seeds fiducial markers implanted). I have gold seeds.

@vircet thank you. I know there is an Elekta Unity MR Linac at UF Health Radiation Oncology - Davis Cancer Pavilion in Gainesville, FL but I have not heard of any restrictions regarding its use in prostate cancer related to fiducials.

The stronger real time imaging results is a plus.

@bens1 I don't think it's necessarily a restriction in use related to fiducials. It seems to me that the cancer center decided to use the MR-Linac for patients who have greater risks due to inability to have the fiducial markers implanted, or other complex issues. If the cancer center retired all their older Elektas, and every patient lined up to the MR-Linac, the waiting time for treatments will be very long. I would have preferred the Linac, but my RO assured me that they have tested all their Elektas and they are all good.

Hello all, the indwelling Foley catheter that you described; is this also called a suprapubic cathetor?

@l700, an indwelling Foley catheter and a suprapubic catheter are slightly different. While both are types of indwelling catheters, they differ in their insertion point. An indwelling Foley catheter is typically inserted through the urethra, while a suprapubic catheter is inserted through a small incision in the lower abdomen, above the pubic bone.

You can learn more about the different types in this article:
- Types of urinary catheters https://www.nhs.uk/conditions/urinary-catheters/types/

Will you be needing a catheter soon?

Thank you for your post.

My husband is self catheterizing himself right now when needed.
The Urologist is ordering a Urodynamic testing and CT scan to see why his bladder may not be fully emptying. They may be some bladder obstruction or urethra damage after radiation.

Hoping to get some type of answer to this problem.

I know this thread is a few months old, but when I was researching treatments I went to UF Gainesville specifically to investigate the MR Linac and was told they would not offer me that treatment as it is a limited resource they save for cancers that need the accuracy more than prostate cancer. Kind of a wasted trip, but at least my son was a student there and we had dinner.

In the cancer center where I had my SBRT, I was told that they also use the MR Linac for prostate patients who aren't able to have the gold seed fiducial markers implanted on them. These patients will therefore receive MRI&guided radiotherapy. As I had gold seeds implanted, I received MRI-guided radio planning with a mini-CT scan before each treatment. With the wider margin in the older Elekta, plus I didn't have SpaceOAR, I might have had some damage in my rectum. I noticed some mucus & blood in my week-3 post SBRT, that cleared on week-4. Somebody indicated to me that the mucus meant the radiated healthy cells were self-repairing, the veins were still sensitive hence the little blood on the stool as it moved out. I hope this is true. Other than this, I don't know if MRI Linac + SpaceOAR would have prevented the bleeding on week-3. I'm now on week-8 post-SBRT.
How was your (and others) experience sans MRI-guided radiotherapy?