What is your preferred approach in a patient unable to fill their bladder during prostate radiotherapy?

If a patient is willing to do a penile clamp or foley, then sure, go for it. Some patients want to 'do everything' and either is reasonable. Whether or not they need to is another question.

Most Grade 3+ GU toxicity is either hemorrhage or stricture. Unfortunately, there isn't great data for any con...

Over the years I have tried all of these strategies, except underdosing the prostate/involved SV. I find the foley more traumatic, increasing the chance of hematuria, dysuria, and infection, and causes a lot of bladder spasms when concurrent with radiation. My preference when the bladder is truly em...

Great answers so far, with a nice evidence review by @Dr. First Last. I agree with others here that the evidence for full bladder is very weak. @Dr. First Last has also shown good outcomes with empty bladder.

There are two RCTs looking at this, which will hopefully allow us to definitively put the ...

All listed solutions are reasonable approaches. I like to have a protocol of bladder prep such as - empty the rectum/bladder 1 hour prior to anticipated treatment time, then start drinking 16 oz (or other desired quantity), use a penile clamp if the patient cannot hold the bladder. Use a mobile blad...