title: Sexual potency preservation and quality of life after prostate brachytherapy and low-dose tadalafil.
abstract: OBJECTIVE
  To prospectively determine sexual function, bother, and potency preservation in men treated with prostate brachytherapy and twice-weekly tadalafil.
  
  
  METHODS
  From 2005 to 2011, men treated with low-dose-rate prostate brachytherapy were treated on a prospective registration study. All patients were prescribed tadalafil 10mg twice weekly. The expanded prostate cancer index composite questionnaire was administered before treatment and at each followup. A subgroup analysis of men with sexual potency at baseline was performed.
  
  
  RESULTS
  A total of 237 men were analyzed. Median age was 64 years (range, 44-86). Median followup was 24.8 months (range, 1-60). At baseline, 175 men (74%) reported erections firm enough for sexual activity and 148 (62%) were potent (erections firm enough for intercourse). Statistically significant changes in sexual function/bother were appreciated from baseline throughout the analysis period, although absolute changes were relatively small and did not meet criteria for clinical significance. At 24-months followup, 72% reported erections firm enough for sexual activity and 56% were potent. Of men with potency at baseline, 89% had erections firm enough for sexual activity and 76% remained potent 24 months after treatment.
  
  
  CONCLUSIONS
  Peri-procedural tadalafil and prostate brachytherapy resulted in high rates of sexual potency preservation and no clinically significant effect on sexual quality of life.
authors.affiliation: Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX. Electronic address: tpugh@mdanderson.org.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Pugh
authors.affiliation: Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX.
authors.forename: Usama
authors.initials: U
authors.lastname: Mahmood
authors.affiliation: Department of Urology, The University of Texas M. D. Anderson Cancer Center, Houston, TX.
authors.forename: David A
authors.initials: DA
authors.lastname: Swanson
authors.affiliation: Department of Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, TX.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Munsell
authors.affiliation: Department of Urology, The University of Texas M. D. Anderson Cancer Center, Houston, TX.
authors.forename: Run
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Radiation Physics, The University of Texas M. D. Anderson Cancer Center, Houston, TX.
authors.forename: Rajat J
authors.initials: RJ
authors.lastname: Kudchadker
authors.affiliation: Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX.
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Bruno
authors.affiliation: Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Frank
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D002243:Carbolines / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D007172:Erectile Dysfunction / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000528:radiation effects; D058986:Phosphodiesterase 5 Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000534:rehabilitation; D011788:Quality of Life; D011832:Radiation Injuries / Q000209:etiology; D011795:Surveys and Questionnaires; D000068581:Tadalafil
chemical_list: D002243:Carbolines; D058986:Phosphodiesterase 5 Inhibitors; D000068581:Tadalafil
keywords: Brachytherapy; EPIC; Erectile dysfunction; Prostate cancer; Tadalafil