Clinical efficacy of combination therapy with an alpha blocker and low-dose sildenafil on post-therapy lower urinary tract symptoms after low-dose-rate brachytherapy for prostate cancer

PURPOSE - To investigate the efficacy of tamsulosin monotherapy and tamsulosin with low-dose sildenafil combination therapy on lower urinary tract symptoms (LUTS) following low-dose-rate (LDR) brachytherapy in early prostate cancer patients.

METHODS - From March 2008 to June 2014, of the 212 prostate cancer patients with a Gleason score ≤7 who received LDR brachytherapy, 80 patients with a prostate volume ≤35 g and progressed LUTS following implantation were selected. All 80 patients took tamsulosin 0. 4-mg monotherapy until 1 month after implantation. Then, the patients were divided into two groups; 45 patients received tamsulosin 0. 4-mg monotherapy, and 35 patients received tamsulosin 0. 4-mg plus sildenafil 25-mg combination therapy due to erectile dysfunction. LUTS were compared between the two groups using the International Prostate Symptom Score (IPSS), the mean maximum flow rate (Q max) and the pre-implantation post-voiding residual (PVR) volume at 1 and 3 months after implantation.

RESULTS - The pre-implantation total IPSS, Q max and PVR for the monotherapy and combination therapy groups were 14. 0 ± 6. 7, 14. 3 ± 3. 2 ml/s and 36. 3 ± 16. 7 ml and 15. 3 ± 5. 6, 13. 7 ± 4. 5 ml/s and 39. 0 ± 23. 4 ml, respectively. At 1 month post-implantation, both groups showed increases in total IPSS and PVR, but no statistically significant differences were observed (P = 0. 078, P = 0. 23). At 3 months post-implantation, the combination therapy group showed a greater decrease in total IPSS compared with the monotherapy group (P = 0. 035), but there were no statistically significant differences in the Q max and PVR between the two groups.

CONCLUSIONS - Tamsulosin plus low-dose sildenafil combination therapy is a beneficial treatment for post-implantation progression of LUTS.

World journal of urology. 2016 Feb 11 [Epub ahead of print]

Young Dong Yu, Moon Hyung Kang, Chang Il Choi, Hyun Soo Shin, Jong Jin Oh, Dong Soo Park

Department of Urology, CHA Bundang Hospital, CHA University College of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam, 463-712, Korea. , Department of Urology, CHA Bundang Hospital, CHA University College of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam, 463-712, Korea. , Department of Urology, CHA Bundang Hospital, CHA University College of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam, 463-712, Korea. , Department of Radiation Oncology, CHA Bundang Medical Center, CHA University, Seongnam, Korea. , Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea. , Department of Urology, CHA Bundang Hospital, CHA University College of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam, 463-712, Korea. 

PubMed