Focus on Silodosin: Pros and Cons of Uroselectivity

Abstract

Medical management of lower urinary tract symptoms related to benign prostatic obstruction engages healthcare professionals worldwide. Currently, alpha-1 adrenergic antagonists are strongly recommended as first-line therapy for patients with moderate to severe symptoms because of their safety, efficacy and good tolerability. These agents are highly heterogeneous in terms of pharmacological selectivity for the adrenergic receptor subtypes with silodosin being the agent characterized by the highest α 1A /α 1B affinity ratio. This property has been proposed to confer to silodosin advantages in terms of bladder outlet obstruction improvement and lower incidence of cardiovascular side effects at the cost of a higher incidence of ejaculatory dysfunction. These aspects should be carefully taken in consideration when personalizing medical therapy for lower urinary tract symptoms related to benign prostatic obstruction.

The Efficacy and Safety of Silodosin for the Treatment of Benign Hyperplasia prostate: A Systematic Review

“…Additionally, dosage adjustments are necessary for patients with renal insufficiency. 7,8 There is no recent review about the efficacy and safety of silodosin, also comparing this medication to other α1 adrenoceptor antagonist. Here, we aim to systematically review the efficacy and safety of silodosin, whether it is recommended to use in daily practice as choices of benign prostate hyperplasia or not.…”

A Cost–Benefit Analysis of Bipolar TURP for the Treatment of Bladder Outflow Obstruction

“…3,4 After failure of medical treatment, the standard referral surgical techniques are transurethral resection of the prostate (TURP) for low-to medium-sized prostate volumes (PV; >80 cc), or open prostatectomy (OP) for higher PV. [5][6][7][8] Since its first adoption in 2001, the bipolar energy appeared to improve TURP safety in comparison to monopolar TURP (M-TURP), in terms of reduced amount of delivered energy to achieve thermal cutting/ vaporization of tissue, and lower risk of TUR syndrome related to saline irrigation. 9,10 In the last decade, many other technologies have been purposed and validated.…”