Ejaculatory dysfunction caused by the new α₁‐blocker silodosin: A preliminary study to analyze human ejaculation using color Doppler ultrasonography

Abstract

Objectives: In order to clinically investigate the mechanism of ejaculatory dysfunction attributable to the a1-blocker silodosin, a real-time observation of ejaculation by healthy males was performed. Methods: Following intake of silodosin, a newly developed selective a1-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. Results: 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. Conclusions: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.

Orgasm is preserved regardless of ejaculatory dysfunction with selective α1A-blocker administration

“…[1][2][3][4][5] Recent studies have highlighted the influence of a1-blockers on ejaculatory function. [6][7][8][9][10] A loss of seminal emission has been recently postulated as one of the mechanisms of abnormal ejaculation. 7,8 Highly selective a1-adrenoceptor subtype-A antagonists (a1A-blockers) cause a high incidence of ejaculatory dysfunction.…”

Sexual Impact of Treatment of Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia

“…Interestingly, the primary mechanism by which A1Bs cause EjD may not be retrograde ejaculation as previously described. Instead, recent evidence points toward a significant failure of emission that may be the primary ejaculatory derangement that results from A1B use [4][5][6][7].…”

The impact and management of sexual dysfunction secondary to pharmacological therapy of benign prostatic hyperplasia

“…In only one of these three cases did the patient have a small amount of semen exit through the urethral orifice as well as into the bladder. There was no documentation of any seminal fluid traveling into the bladder in those males not using silodosin (40). …”