Efficacy of tadalafil against lower urinary tract symptoms after low-dose-rate brachytherapy in prostate cancer patients

Abstract

This study was performed to evaluate the effects of addition of tadalafil to tamsulosin in the treatment of brachytherapy patients with lower urinary tract symptoms (LUTS). Methods: Localized prostate cancer patients who developed LUTS after low-dose-rate brachytherapy (LDR-BT) were first treated with alpha-1 blockers (tamsulosin, 0.2 mg per day). Those still suffering from LUTS were additionally treated with phosphodiesterase type 5 inhibitor (tadalafil, 5 mg/day). LUTS was evaluated by the International Prostate Symptom Score (IPSS), IPSS Quality of Life (QOL) score, Overactive Bladder Symptom Score (OABSS), and the International Index of Erectile Function 5 (IIEF5) score before brachytherapy, before treatment with tadalafil, and after three months of treatment with tadalafil. Results: Twenty-three patients were enrolled in the study. Each subscore of the IPSS (storage symptom, voiding symptom, and postvoiding symptom) and the QOL score improved, but OABSS and IIEF5 did not show significant recovery after addition of tadalafil treatment. When patient characteristics and each question score were surveyed, time from seed implantation until treatment with tadalafil showed the strongest correlation with recovery. Conclusions: Addition of tadalafil to tamsulosin treatment was effective against LUTS in localised prostate cancer patients after brachytherapy.

Impact of low‐dose tadalafil on adverse events after low‐dose‐rate brachytherapy for prostate cancer: A bi‐center randomized open‐label trial

“…However, the effect of PDE5 inhibitor treatment alone was not evaluated in the report. We previously reported that tadalafil add‐on to tamsulosin is effective in attenuating LUTS after LDR as a preliminary study for this trial 11 . In this trial, we confirmed the efficacy of tadalafil, compared with tamsulosin, on LUTS after LDR.…”

“…We previously reported that tadalafil add-on to tamsulosin is effective in attenuating LUTS after LDR as a preliminary study for this trial. 11 In this trial, we confirmed the efficacy of tadalafil, compared with tamsulosin, on LUTS after LDR. ED is also one of the problems affecting QoL after LDR for localized prostate cancer.…”

“…We evaluated the attenuating effect of tadalafil on ED after LDR, expecting low‐dose tadalafil to be effective in improving ED 11 . The effect of tadalafil on ED after LDR was statistically superior to that of tamsulosin in the present study.…”

“…The usefulness of the PDE5 inhibitor tadalafil, by contrast, has been shown for the treatment of male LUTS with benign prostatic hyperplasia and ED 7–10 . We hypothesized that tadalafil may also have therapeutic effects on LUTS after LDR, and have previously reported the effect of tadalafil as an add‐on therapy for LUTS and ED after LDR 11 . However, our previous study was a retrospective single‐arm trial.…”

“…[7][8][9][10] We hypothesized that tadalafil may also have therapeutic effects on LUTS after LDR, and have previously reported the effect of tadalafil as an add-on therapy for LUTS and ED after LDR. 11 However, our previous study was a retrospective single-arm trial. Although tadalafil may theoretically be useful for the management of LUTS and ED after LDR, its role in this setting has not yet been established.…”