Focus on Silodosin: Pros and Cons of Uroselectivity

Abstract

Gianluigi Califano,1 Claudia Collà Ruvolo,1 Massimiliano Creta,1 Marco Capece,1 Roberto La Rocca,1 Giuseppe Celentano,1 Luigi Napolitano,1 Francesco Paolo Calace,1 Gianluca Spena,1 Francesco Trama,1 Felice Crocetto,1 Francesco Mangiapia,1 Nicola Longo,1 Ferdinando Fusco2 1Department of Neurosciences, Reproductive Sciences and Odontostomatology – Federico II University of Naples, Naples, Italy; 2Department of Urology, Luigi Vanvitelli University of Naples, Naples, ItalyCorrespondence: Massimiliano CretaDepartment of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, via Sergio Pansini 5, Naples 80131, ItalyTel/Fax [phone]Email [email protected]: 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 α1A/α1B 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.Keywords: alpha-1 adrenergic antagonists, benign prostate enlargement, lower urinary tract symptoms, bladder outlet obstruction

Keywords

• alpha-1 adrenergic antagonists
• benign prostate enlargement
• lower urinary tract symptoms
• bladder outlet obstruction.