silodosin and Sexual-Dysfunction--Physiological

To investigate the therapeutic effects of commonly used selective α-adrenergic receptor antagonists (α-ARA) on benign prostatic hyperplasia (BPH).. PubMed, Embase and CNKI databases were searched for the literature about selective α-ARAs for the treatment of BPH and the information was extracted on the common adverse reactions in the course of treatment. Multivariate meta-analysis was conducted to investigate the therapeutic effects of different α-ARAs.. The total rates of adverse effects of silodosin and tamsulosin were the highest, 51.9% and 34.0% respectively, with the highest incidences of headache (38.3%), weakness (23.6%) and dizziness (17.5%). Besides, tamsulosin ranked the first in inducing sexual dysfunction of the male patients with BPH (70.4%).. Doxazosin is preferable as the first-choice treatment of BPH for its therapeutic effect and improvement of the patient's quality of life. Silodosin and tamsulosin, however, can be selectively used according to the patient's specific tolerance to different adverse effects.. 目的： 探究常用选择性α肾上腺素能受体拮抗剂治疗良性前列腺增生（BPH）的药物疗效。方法： 通过检索PubMed、Embase和CNKI数据库，筛选选择性α肾上腺素能受体拮抗剂治疗BPH的国内外相关文献，提取有关治疗过程中患者发生各种常见不良反应的信息，通过多变量meta分析探索不同α肾上腺素能受体拮抗剂的治疗效果。结果： 共检索237篇相关文献，最终纳入研究13篇。特拉唑嗪和坦索洛新的总不良反应发生率最高，分别是51.9%和34.0%，其中以头痛、虚弱无力和眩晕为发生率最高的不良反应，平均发生率分别约为38.3%、23.6%和17.5%。此外，坦索洛新对BPH患者的性功能方面的影响也居于首位（70.4%）。结论： 多沙唑嗪可以作为BPH患者的首选治疗药物，提高治疗效果及生活质量，而特拉唑嗪和坦索洛新需要根据患者对不同不良反应的耐受性选择性应用。.

Topics: Adrenergic alpha-Antagonists; Doxazosin; Humans; Indoles; Male; Network Meta-Analysis; Prostatic Hyperplasia; Quality of Life; Sexual Dysfunction, Physiological; Tamsulosin

As the clinical effects of the available α1-adrenoceptors (ARs) blockers are usually considered comparable for treatment in patients suffering from lower urinary tract symptoms (LUTS) secondary to prostatic enlargement, officially recognised guidelines do not make specific recommendations regarding the choice of which agent should be considered according to the patient's characteristics.. To analyse data supporting the use of silodosin, a highly selective once-daily dosing α1-ARs blocker, in different daily clinical practice scenarios.. A structured literature review was performed using data retrieved from articles assessing the role of silodosin in the management of LUTS secondary to benign prostatic hyperplasia (BPH). A literature search of English language publications was performed using MEDLINE(®) and Web of Science from 2000 to 2012 using the terms LUTS; BPH; silodosin; α1-ARs blockers. The papers with the highest level of evidence were identified and represent the basis of the present review.. Available data coming from basic research analyses, randomised trials and prospective studies showed that silodosin is efficacious for the initial management of patients with LUTS. Clinical developmental safety data from patients receiving silodosin with concomitant antihypertensive therapy do not indicate an increase in risk of orthostatic hypotension. In this context, a recent study demonstrated that silodosin can be safely administered to patients who are consensually assuming phosphodiesterase type 5 inhibitors. A recent randomised crossover study comparing the efficacy of silodosin and tamsulosin in patients with LUTS showed that further significant improvement was observed after switching to silodosin treatment, while worsening or little improvement was observed after switching to tamsulosin treatment. Preliminary results seem to demonstrate a potential role of silodosin in the treatment of chronic prostatitis/chronic pelvic pain syndrome and to facilitate ureteral stone passage, as well.. When considering the above cited pharmacological and clinical characteristics of the drug, silodosin can be considered in the following clinical scenario: patients suffering from moderate-severe nocturia, patients with low normal blood pressure levels and patients concomitantly treated with antihypertensive medications, patients concomitantly treated with phosphodiesterase type 5 inhibitors, patients not satisfied (for efficacy or tolerability) with previous treatment with other α1-ARs blockers.. Silodosin is efficacious for the initial management of patients with LUTS. Silodosin has a good cardiovascular safety profile and can be considered an option in patients with cardiovascular co-morbidities. It seems to be especially beneficial in patients with nocturia alone or presenting with the symptomatic trial nocturia-frequency-incomplete emptying. Patients on phosphodiesterase type 5 inhibitors treatment can be safely managed with silodosin.

Topics: Adrenergic alpha-1 Receptor Antagonists; Aged; Aged, 80 and over; Cardiovascular Diseases; Ejaculation; Humans; Indoles; Lower Urinary Tract Symptoms; Male; Middle Aged; Multicenter Studies as Topic; Patient Selection; Phosphodiesterase 5 Inhibitors; Prospective Studies; Prostatism; Randomized Controlled Trials as Topic; Sexual Dysfunction, Physiological; Treatment Outcome; Urodynamics; Urological Agents

To evaluate the sexual side effects including ejaculation after silodosin treatment in potent men with regular sexual activity, as well as possible alterations in seminal vesicle volume.. Sexually active patients aged ≥ 40 years with moderate to severe lower urinary tract symptoms were enrolled prospectively. International Prostate Symptom Score (IPSS) and Quality of Life (QoL), International Index of Erectile Function (IIEF) questionnaire, ejaculation frequency, and seminal vesicle volumes measured by transrectal ultrasonography were determined at study entry, and silodosin 8 mg/d was prescribed for 4 weeks. Alterations in IPSS-QoL, all domains of IIEF, ejaculation frequency, seminal vesicle volumes, and patient-reported side effects were evaluated after silodosin treatment.. Thirty patients were included, and mean age was 56.7 ± 6.9 years (44-70 years). IPSS-total, IPSS-storage, and IPSS-voiding subscores and QoL were significantly improved after treatment. Despite a slight decrease in erectile function domain of IIEF (26.7 ± 1.9 vs 22.9 ± 7.5; P <.05), no significant change was determined for orgasmic functions, sexual desire, intercourse satisfaction, and overall satisfaction. Ninety percent of patients (27 of 30) had impaired ejaculation, and seminal vesicles were significantly enlarged at the end of treatment (8.1 ± 6.4 vs 16.4 ± 8.2 cc; P <.001).. Impaired ejaculation is a common problem for sexually active men treated with silodosin, and this may result in the slight decrease in erectile functions. Enlargement of seminal vesicles may represent for the loss of seminal emission and accumulation of seminal vesicle secretion. Further studies are required for better clarifying the effects of silodosin on sexual functions including ejaculatory functions.

Topics: Adrenergic alpha-1 Receptor Antagonists; Adult; Aged; Ejaculation; Humans; Hypertrophy; Indoles; Lower Urinary Tract Symptoms; Male; Middle Aged; Prospective Studies; Prostatic Hyperplasia; Quality of Life; Seminal Vesicles; Sexual Behavior; Sexual Dysfunction, Physiological

The treatment with α1-blockers in patients complaining of lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) is associated with potential adverse events (AEs), thus including ejaculatory dysfunction (EjD). We sought to assess the effects of a 3-month course of silodosin 8 mg daily dosing on sexual functioning, mainly including ejaculation and orgasm, in a cohort of 100 consecutive sexually active men in the real-life setting. Patients completed the International Index of Erectile Function-Orgasmic Function (IIEF-OF) domain and the International Prostate Symptom Score (IPSS) both at baseline and at survey. Likewise, patients completed a 16-item self-administered questionnaire with closed questions also including specific questions regarding treatment-related adverse events on sexual functioning. Rates and predictors of OF impairment and drug discontinuation were investigated. At survey, silodosin resulted highly effective in improving IPSS-total and subscales (all p < 0.01). Anejaculation, hypospermia, reduced or absent orgasmic feeling, low sexual desire and erectile dysfunction were subjectively reported by 48 (48%), 23 (23%), 11 (11%), 6 (6%), 7 (7%) and 11 (11%) patients respectively. Overall, a reduction in IIEF-OF domain score was observed in 64 (64%) patients. Patients with decreased IIEF-Q9 and/or IIEF-Q10 scores were significantly younger than those without any decrease (p = 0.02). Of all, only 7% of the patients discontinued silodosin because of anejaculation. Silodosin confirms to be highly effective in patients with LUTS/BPH; of them, almost 70% report either anejaculation or hypospermia, with a concomitant OF impairment in 17% of the patients. Younger patients showed higher rates of a concomitant impairment of ejaculation and OF. Overall, anejaculation caused drug discontinuation in 7% of the patients.

Topics: Adrenergic alpha-1 Receptor Antagonists; Adult; Aged; Aged, 80 and over; Ejaculation; Humans; Indoles; Lower Urinary Tract Symptoms; Male; Middle Aged; Oligospermia; Prevalence; Prostatic Hyperplasia; Risk Factors; Sexual Behavior; Sexual Dysfunction, Physiological; Spermatogenesis; Surveys and Questionnaires; Time Factors; Treatment Outcome; Urological Agents

Topics: Adrenergic alpha-1 Receptor Antagonists; Ejaculation; Humans; Indoles; Male; Sexual Dysfunction, Physiological; Stress, Psychological; Young Adult

Topics: Adrenergic alpha-1 Receptor Antagonists; Ejaculation; Humans; Indoles; Male; Sexual Dysfunction, Physiological; Stress, Psychological

Premature ejaculation is a common sexual problem, as is erectile dysfunction. We evaluated silodosin, a highly selective α1A-adrenoceptor antagonist, as a new treatment option for premature ejaculation. α1-Adrenoceptor antagonists are widely used for lower urinary tract symptoms, and clinical studies on silodosin have shown excellent clinical efficacy for lower urinary tract symptoms. However, compared with other α1-adrenoceptor antagonists, silodosin appeared to suppress ejaculation in a relatively higher percent of trial participants. This suppression of ejaculation by silodosin suggested its potential for treating premature ejaculation. Consequently, we evaluated the feasibility of off-label silodosin as a new treatment option for premature ejaculation. Eight patients suffering premature ejaculation were treated with silodosin. Silodosin (4 mg) was given 2 h before sexual intercourse. Intravaginal ejaculatory latency time, premature ejaculation profile item, clinical global impression change in premature ejaculation and systemic adverse events were recorded. Intravaginal ejaculatory latency time was significantly prolonged (from 3.4 min to 10.1 min, P = 0.003). All patients answered better (much better) or slightly better for their own premature ejaculation problem compared with pretreatment condition in the clinical global impression change. Premature ejaculation profile also significantly improved. Two (25%), three (37.5%) and seven patients (87.5%) experienced anejaculation, reduced semen volume and discomfort during orgasm, respectively. However, these problems were not of major concern for the participants. No systemic adverse effects were reported. The current results support the possible use of silodosin as a new treatment option for premature ejaculation, and suggest that a placebo controlled study assessing its clinical usefulness would be worthwhile.

Topics: Adrenergic alpha-1 Receptor Antagonists; Adult; Aged; Ejaculation; Humans; Indoles; Interpersonal Relations; Male; Middle Aged; Self Report; Semen; Sexual Dysfunction, Physiological; Time Factors

In order to clinically investigate the mechanism of ejaculatory dysfunction attributable to the alpha1-blocker silodosin, a real-time observation of ejaculation by healthy males was performed.. Following intake of silodosin, a newly developed selective alpha1-blocker for benign prostatic hypertrophy, ejaculation was dynamically observed using color Doppler ultrasound in three healthy males. Normal ejaculation was also investigated in the same manner.. With silodosin intake, no antegrade ejaculation was observed in cases 1 or 2. In case 1, seminal fluid slowly but continuously flowed out from the seminal vesicles into the bladder. In case 2, only a small amount of seminal fluid flowed into the bladder during the ejaculatory sensation. In case 3, ejection of a small amount of semen from the external urethral orifice was observed and inflow of a small amount of seminal fluid into the bladder was also captured. Without silodosin intake, all three subjects exhibited antegrade ejaculation.. The mechanism of ejaculatory dysfunction is intricately related to retrograde ejaculation (retrograde inflow of seminal fluid), insufficient contraction of the seminal vesicles, and insufficient rhythmic contraction of the muscles of the pelvic floor.

Topics: Adrenergic alpha-Antagonists; Adult; Ejaculation; Humans; Indoles; Male; Sexual Dysfunction, Physiological; Ultrasonography, Doppler, Color; Young Adult