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


Authors: Zelefsky, M. J.; Shasha, D.; Branco, R. D.; Kollmeier, M.; Baser, R. E.; Pei, X.; Ennis, R.; Stock, R.; Bar-Chama, N.; Mulhall, J. P.
Article Title: Prophylactic sildenafil citrate improves select aspects of sexual function in men treated with radiotherapy for prostate cancer
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. © 2014 by American Urological Association Education and Research, Inc.
Keywords: controlled study; aged; patient satisfaction; placebo; cancer radiotherapy; randomized controlled trial; radiotherapy; prostate cancer; prostatic neoplasms; prostate; brachytherapy; headache; external beam radiotherapy; double blind procedure; erectile dysfunction; sildenafil; blurred vision; human; male; priority journal; article
Journal Title: Journal of Urology
Volume: 192
Issue: 3
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2014-09-01
Start Page: 868
End Page: 874
Language: English
DOI: 10.1016/j.juro.2014.02.097
PROVIDER: scopus
PUBMED: 24603102
DOI/URL:
Notes: Export Date: 2 September 2014 -- CODEN: JOURA -- Source: Scopus
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MSK Authors
  1. Raymond E Baser
    67 Baser
  2. Michael J Zelefsky
    649 Zelefsky
  3. John P Mulhall
    408 Mulhall
  4. Marisa A Kollmeier
    149 Kollmeier
  5. Xin Pei
    100 Pei
  6. Rebekah Diane Branco
    1 Branco
  7. Daniel Shasha
    2 Shasha