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

Abstract

Abbreviations & Acronyms ADT = androgen deprivation therapy ED = erectile dysfunction FAS = full analysis set IPSS = International Prostate Symptom Score LDR = low-dose-rate brachytherapy LUTS = lower urinary tract symptoms N.S. = not significant OABSS = overactive bladder symptom score PDE5 = phosphodiesterase-5 PSA = prostate-specific antigen PVR = postvoid residual urine volume Q max = maximum urinary flow rate QoL = quality of life SAS = safety analysis set SHIM = Sexual Health Inventory for Men UrD30% = minimal dose received by 30% of the urethral volume a1ARA = alpha 1-adrenergic receptor antagonist

Factors affecting urinary frequency after low‐dose‐rate brachytherapy for prostate cancer

“…If there are no contraindications, we prescribe postoperative α1‐blockers at our hospital according to previous reports that α1‐blockers improved LUTS after seed implant while they did not reduce the incidence of urinary retention or bladder outlet obstruction 21,25 . Tadalafil may be as effective as α1‐blockers 26 . The combination of tamsulosin and trospium, an anticholinergic, was more effective than tamsulosin monotherapy 27 .…”

Editorial Comment to Comparison of disease‐specific quality of life in prostate cancer patients treated with low‐dose‐rate brachytherapy: A randomized controlled trial of silodosin versus naftopidil

“…This is the first report showing differences in bowel and sexual functions in the early post‐LDR‐BT period among different α‐1 subtypes, and the results might help in choosing a drug based on patients’ preoperative symptoms. Regarding sexual function, it was reported that tadarafil, a phosphodieserase‐5 inhibitor, provided better Sexual Health Inventory for Men scores after LDR‐BT than tamsulosin, an α‐1 antagonist 4 . In actual clinical practice, to maintain quality of life after LDR‐BT, it would be necessary to evaluate lower urinary tract functions (including International Prostate Symptoms Score, Overactive Bladder Symptom Score, uroflowmetry, post‐void residual urine volume), sexual function including Sexual Health Inventory for Men score and bowel function before treatment, and to administer an α‐1 antagonist suitable for each patient while considering the subtypes.…”

“…Regarding sexual function, it was reported that tadarafil, a phosphodieserase-5 inhibitor, provided better Sexual Health Inventory for Men scores after LDR-BT than tamsulosin, an a-1 antagonist. 4 In actual clinical practice, to maintain quality of life after LDR-BT, it would be necessary to evaluate lower urinary tract functions (including International Prostate Symptoms Score, Overactive Bladder Symptom Score, uroflowmetry, post-void residual urine volume), sexual function including Sexual Health Inventory for Men score and bowel function before treatment, and to administer an a-1 antagonist suitable for each patient while considering the subtypes. If necessary, concomitant use of phosphodieserase-5 inhibitor and overactive bladder drugs, bowel control and dietary instructions should be considered.…”