URO ONCO

Welcome, this website is intended for all international healthcare professionals in uro-oncology. By clicking the link below you are declaring and confirming that you are a healthcare professional.

You are here

Prophylactic sildenafil citrate improves select aspects of sexual function in men treated with radiotherapy for prostate cancer.

Zelefsky MJ, Shasha D, Branco RD, Kollmeier M, Baser RE, Pei X, Ennis R, Stock R, Bar-Chama N, Mulhall JP.

Comment from Henk van der Poel: Sildenafil improved erectile function 12 months after external beam radiotherapy for prostate cancer compared to placebo in a randomized controlled study.

J Urol. 2014 Sep;192(3):868-74.

Abstract

PURPOSE:

We studied adjuvant daily sildenafil citrate during and after radiotherapy for prostate cancer for erectile function preservation.

MATERIALS AND METHODS:

We performed a randomized, prospective trial of 279 patients with localized prostate cancer treated with radiotherapy who received sildenafil citrate (50 mg daily) or placebo (2:1 randomization). Medication/placebo was initiated 3 days before treatment and continued daily for 6 months. Before therapy and 3, 6, 9, 12, 18 and 24 months after radiotherapy patients completed the IIEF questionnaire, including the erectile function domain, the I-PSS questionnaire and the RAND SF-36®. All IIEF domains were scored.

RESULTS:

At 12 months erectile function scores were better for sildenafil citrate than placebo (p = 0.018), 73% of patients on sildenafil citrate vs 50% on placebo had mild/no erectile dysfunction (p = 0.024) and the sildenafil citrate arm had superior overall satisfaction (p = 0.027) and IIEF total scores (p = 0.043). At 24 months erectile function and IIEF scores were no longer significantly better for sildenafil citrate (p = 0.172 and 0.09, respectively) and yet overall satisfaction scores were higher (p = 0.033). Sexual desire scores in patients who received sildenafil citrate were higher at 24 months although they had completed drug therapy 18 months previously (p = 0.049). At 24 months 81.6% of patients on sildenafil citrate and 56.0% of those on placebo achieved functional erection with or without erectile dysfunction medication (p = 0.045).

CONCLUSIONS:

Daily sildenafil citrate during and after radiotherapy for prostate cancer was associated with improved overall sexual function compared with placebo for various sexual function domains. To our knowledge this is the largest randomized, prospective, controlled trial to show the usefulness of a phosphodiesterase-5 inhibitor as a rehabilitation strategy in patients with prostate cancer who received radiation therapy.

Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

erectile dysfunction; prostate; prostatic neoplasms; radiotherapy; sildenafil

E-Alert

Subscribe to our E-Alert to keep up to date with the new items in the Resource Centre

Subscribe

URO ONCO is made possible by an unrestricted educational grant from:

The editorial independence of the resource centre is mandatory and recognized by the EAU and Elsevier.

The journal articles, videos and statements published on the resource centre have been selected independently and without influence from Elsevier, European Urology Editors or the sponsor and do not necessarily reflect their opinions or views.