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Prophylactic versus therapeutic alpha-blockers after permanent prostate brachytherapy
Gregory S Merrick1, Wayne M Butler, Kent E Wallner
1Schiffler Cancer Center, Wheeling Hospital, Wheeling, West Virginia 26003-6300, USA.
Urology
|October 19, 2002
Summary
Prophylactic alpha-blockers significantly reduce urinary morbidity after prostate brachytherapy, leading to faster symptom recovery. However, they do not impact urinary retention or the need for surgery.
Area of Science:
- Urology
- Oncology
- Radiotherapy
Background:
- Permanent prostate brachytherapy is a treatment for prostate cancer.
- Urinary morbidity is a common side effect of this procedure.
Purpose of the Study:
- To compare the effects of prophylactic versus therapeutic alpha-blockers on urinary morbidity following permanent prostate brachytherapy.
- To identify factors influencing acute urinary morbidity.
Main Methods:
- A randomized study of 234 patients with prostate cancer treated with permanent prostate brachytherapy.
- Patients received either prophylactic alpha-blockers before implantation or therapeutic alpha-blockers after implantation.
- Evaluated clinical and treatment parameters, including International Prostate Symptom Score (IPSS).
Main Results:
- Prophylactic alpha-blocker use led to a significantly faster return of IPSS to baseline compared to therapeutic or no alpha-blocker use.
- The time to IPSS normalization was shorter with prophylactic alpha-blockers (mean 4 months) versus others (mean 10 months).
- Alpha-blocker use did not affect prolonged urinary catheter dependency or the need for postimplant surgery.
Conclusions:
- Prophylactic alpha-blockers are more effective than therapeutic or no use in reducing urinary morbidity after prostate brachytherapy.
- Prophylactic alpha-blockers expedite urinary symptom recovery but do not alter rates of urinary retention or surgical intervention.