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 an...

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 @James Janopaul-Naylor. I agree with others here that the evidence for full bladder is very weak. @Vedang Murthy has also shown good outcomes with empty bladder.  There are two RCTs looking at this, which will hopefully allow us to definitiv...

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...