Sexual potency preservation and quality of life after prostate brachytherapy and low-dose tadalafil

Purpose: To prospectively determine sexual function, bother, and potency preservation in men treated with prostate brachytherapy and twice-weekly tadalafil. Methods and Materials: From 2005 to 2011, men treated with low-dose-rate prostate brachytherapy were treated on a prospective registration study. All patients were prescribed tadalafil 10. mg twice weekly. The expanded prostate cancer index composite questionnaire was administered before treatment and at each followup. A subgroup analysis of men with sexual potency at baseline was performed. Results: A total of 237 men were analyzed. Median age was 64 years (range, 44-86). Median followup was 24.8 months (range, 1-60). At baseline, 175 men (74%) reported erections firm enough for sexual activity and 148 (62%) were potent (erections firm enough for intercourse). Statistically significant changes in sexual function/bother were appreciated from baseline throughout the analysis period, although absolute changes were relatively small and did not meet criteria for clinical significance. At 24-months followup, 72% reported erections firm enough for sexual activity and 56% were potent. Of men with potency at baseline, 89% had erections firm enough for sexual activity and 76% remained potent 24 months after treatment. Conclusions: Peri-procedural tadalafil and prostate brachytherapy resulted in high rates of sexual potency preservation and no clinically significant effect on sexual quality of life.