Efficacy of silodosin in patients undergoing brachytherapy: a randomized trial involving a pressure flow study

• Published in: World journal of urology Vol. 32; no. 6; pp. 1423 - 1432
• Main Authors: Shimizu, Nobutaka, Minami, Takafumi, Sugimoto, Koichi, Saito, Yoshitaka, Yamamoto, Yutaka, Hayashi, Taiji, Tsuji, Hidenori, Nozawa, Masahiro, Yoshimura, Kazuhiro, Ishii, Tokumi, Uemura, Hirotsugu, Nakamatsu, Kiyoshi
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2014; Springer Nature B.V
• Subjects: Adrenergic alpha-1 Receptor Antagonists - therapeutic use; Aged; Brachytherapy - adverse effects; Humans; Indoles - therapeutic use; Lower Urinary Tract Symptoms - drug therapy; Lower Urinary Tract Symptoms - etiology; Lower Urinary Tract Symptoms - physiopathology; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Oncology; Original Article; Prostatic Neoplasms - pathology; Prostatic Neoplasms - physiopathology; Prostatic Neoplasms - radiotherapy; Quality of Life; Treatment Outcome; Urinary Bladder Neck Obstruction - drug therapy; Urinary Bladder Neck Obstruction - etiology; Urinary Bladder Neck Obstruction - physiopathology; Urodynamics; Urology; Pressure flow study; Brachytherapy; Prostatic neoplasms; Alpha-1 antagonists; Silodosin
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-014-1239-z

Purpose
The purpose of the study is to investigate the efficacy of an alpha-1 adrenergic receptor antagonist (silodosin) for the treatment of lower urinary tract symptoms (LUTS) associated with interstitial
125
I implantation for prostate cancer.
Methods
This randomized single-center study involved 105 patients (53 with and 52 without silodosin). Silodosin was postoperatively administered, daily, for 6 months (8 mg/day). Urinary symptoms and pressure flow were evaluated preoperatively and postoperatively at 1, 3, 6, and 12 months.
Results
At 12 months, interstitial
125
I implantation had induced a significant decrease in prostate volume (28.3 ± 11.1–20.5 ± 8.1 g in the silodosin group and 26.1 ± 9.7–17.7 ± 4.9 g in the controls) and the prostate-specific antigen level (7.1 ± 3.6–1.4 ± 1.7 ng/mL in the silodosin group and 8.1 ± 4.3–1.3 ± 1.2 ng/mL in the controls). Significant improvements in the international prostate symptom voiding subscores at 6 months and quality of life at 3 months were observed in those receiving silodosin. The pressure flow studies demonstrated that silodosin had significantly enlarged the bladder capacity when the first non-voiding contraction was seen at 3 and 12 months (3M: 127.1 ± 74.8 vs. 118.2 ± 83.9 mL,
p
 = 0.001; 12M: 123.7 ± 79.3 vs. 100.3 ± 73.4 mL,
p
 = 0.01); however, there were no improvements in the bladder outlet obstruction index (BOOI) or urinary flow.
Conclusions
Silodosin temporarily improved LUTS, but did not improve the BOOI after
125
I implantation in the prostate.