22 Penis Cancer

Penis Cancer 489

21.13: Radio-epithelitis two weeks after the end of brachytherapy, delineating the PTV.

b) Late side effects In assessing the importance of late sequelae, it must to be remembered that with this brachytherapy approach -in contrast to any form of amputation- the organ itself can be spared in 70 - 75% of cases, which avoids a major psychological impairment in body representation. (11,14,25,31) Overall, the complication rate is proportional to the total dose, the dose distribution, and the treated volume. Telangiectasia and/or sclerosis are frequent but do not impact on quality of life. In contrast, urethral stenosis and/or necrosis are less frequent but may have a significant impact on quality of life. (5,11,13,14,30)

Fig 21.14 : Dilatation of urethral stenosis Fig 21.15 : Superficial necrosis of balano-preputial sulcus