title: 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.
abstract: OBJECTIVE
  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.
authors: Department of Urology, CHA Bundang Hospital, CHA University College of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam, 463-712, Korea.
authors: Young Dong
authors: YD
authors: Yu
authors: Department of Urology, CHA Bundang Hospital, CHA University College of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam, 463-712, Korea.
authors: Moon Hyung
authors: MH
authors: Kang
authors: Department of Urology, CHA Bundang Hospital, CHA University College of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam, 463-712, Korea.
authors: Chang Il
authors: CI
authors: Choi
authors: Department of Radiation Oncology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors: Hyun Soo
authors: HS
authors: Shin
authors: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Jong Jin
authors: JJ
authors: Oh
authors: Department of Urology, CHA Bundang Hospital, CHA University College of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam, 463-712, Korea. dsparkmd@cha.ac.kr.
authors: Dong Soo
authors: DS
authors: Park
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage*; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D004359:Drug Therapy, Combination; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D058986:Phosphodiesterase 5 Inhibitors / Q000008:administration & dosage*; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D000068677:Sildenafil Citrate / Q000008:administration & dosage*; D013449:Sulfonamides / Q000008:administration & dosage*; D000077409:Tamsulosin; D016896:Treatment Outcome
chemical_list: D000317:Adrenergic alpha-Antagonists; D058986:Phosphodiesterase 5 Inhibitors; D013449:Sulfonamides; D000068677:Sildenafil Citrate; D000077409:Tamsulosin
keywords: Brachytherapy; Lower urinary tract symptoms; Prostatic neoplasm; Sildenafil