Evolving Role of Silodosin for the Treatment of Urological Disorders – A Narrative Review

Abstract

Use of α-androgenic receptor blockers remains a mainstay therapeutic approach for the treatment of urological diseases. Silodosin is recommended over other α-blockers for the treatment of lower urinary tract symptoms (LUTS) and benign prostate hyperplasia (BPH), due to its high α 1A uroselectivity. Current research data suggest that silodosin is efficacious in the management of various urological diseases. Thus, we herein review the current evidence of silodosin related to its efficacy and tolerability and appraise the available literature that might ultimately aid in management of various urological conditions at routine clinical practice. Literature reveals that silodosin is beneficial in improving nocturia events related to LUTS/BPH. Silodosin exerts effect on relaxing muscles involved in detrusor obstruction, therefore prolonging the need for patients undergoing invasive surgery. Silodosin treatment, either as a monotherapy or combination, significantly improves International Prostate Symptom Score (IPSS) including both storage and voiding symptoms in patients with BPH/LUTS. Patients on other treatment therapies such as phosphodiesterase 5 inhibitors or other α-blockers are well managed with this drug. Steadily, silodosin has proved beneficial in the treatment of other urological disorders such as chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), overactive bladder/acute urinary retention (AUR), premature ejaculation (PE), and prostate cancer post brachytherapy-induced progression. In patients with distal ureteral stones, silodosin treatment is beneficial in decreasing stone expulsion time without affecting stone expulsion rate or analgesic need. Moreover, there were significant improvements in intravaginal ejaculation latency time, quality of life scores, and decrease in PE profile among patients with PE. Silodosin has also demonstrated promising results in increasing the likelihood of successful trial without catheter in patients with AUR and those taking antihypertensive drugs. Reports from Phase II studies have shown promising role of silodosin in the treatment of CP/CPPS as well as facilitating ureteral stone passage. From the robust data in this review, further silodosin treatment strategies in the management of different urological conditions need to be focused on.

Quality Control Assessment of Dutasteride and Silodosin in Capsules and Tablets Employing a Novel Developed HPLC Technique; Evaluation of Stabilities of Dutasteride and Silodosin in Accelerated Degradation

“…Since the relative variance wasn't higher than 0.20% (table 3,4), it was determined that the ruggedness results from lab to lab, equipment to equipment, analyst to analyst and day-to-day fluctuation were repeatable [29]. Small alterations in each of the variables (proportion of acetonitrile; flow rate; temperature) under study had no appreciable impact on the outcomes (table 7,8). This gave evidence of the suggested method's reliability in regular analysis of DTRE and SLDN [29].…”

“…An alpha-blocker is SLDN. To facilitate the simple flow of urine, SLDN acts by soothing the muscles surrounding the prostate gland and bladder exit [8]. DTRE, a 5-alpha-reductase antagonist, aids in prostate gland growth reduction by lowering the quantity of the hormone, which fosters prostate gland progression [9].…”

Therapeutic Approaches for Urologic Chronic Pelvic Pain Syndrome; Management: Research Advances, Experimental Targets, and Future Directions

“…However, using α1 blockers as part of a multimodal approach, which included antibiotics, massage, and neuromuscular agents, significantly improved symptoms compared to single therapies (Shoskes et al, 2003). In addition, recent studies on silodosin provided evidence that the drug was efficacious in improving sexual function, urinary symptoms, and pain in CP/CPPS patients (Jindan et al, 2022). Although α1 blockers have demonstrated their use in reducing LUTS in men (Kim et al, 2019) and in animal studies replicating various aspects of IC/BPS (Liu et al, 2016;Markiewicz et al, 2014), these drugs only recently started to be studied in women with UCPPS diagnosis.…”

“…This article contains no datasets generated or analyzed during the current study. Jindan et al, 2022;Kim et al, 2019;Lander et al, 2019;Liu et al, 2016;Markiewicz et al, 2014;Nickel et al, 2008…”