The role of alpha-blockers in the management of lower urinary tract symptoms in prostate cancer patients treated with radiation therapy

Abstract

Objective: Radiation therapy (RT) is commonly used for the treatment of prostate cancer, either via brachytherapy or external beam, and is often accompanied by dose-related obstructive and irritative lower urinary tract symptoms (LUTS). This review will analyze the current state of knowledge of LUTS secondary to RT for prostate cancer and review treatment options for this complication.

Methods: A review of the literature.

Results: Radiation-induced effects in the lower urinary tract that result in LUTS include injury to peripheral neurons, interstitial fibrosis of the bladder, and loss of muscle fibers in the muscularis propria. LUTS are associated with a diminished quality of life and impaired sexual function. Numerous nonrandomized studies and one randomized study support the proposition that the occurrence of LUTS secondary to RT is effectively mitigated by alpha1-adrenoreceptor blockade.

Conclusions: Basic and clinical science studies as well as clinical guidelines relevant for LUTS secondary to RT suggest that the routine use of alpha1-adrenoreceptor antagonists should be considered in patients treated with RT, either prophylactically or at the earliest sign of LUTS.