https://doi.org/10.4081/aiua.2024.12984

Promising selective α-1 blocker silodosin as a new therapeutic strategy for premature ejaculation and analysis of its drug adverse effect: A systematic review and meta-analysis of randomized controlled trials

Vol. 96 No. 4 (2024)
Submitted: August 29, 2024
Accepted: September 2, 2024
Published: November 11, 2024
Silodosin, premature ejaculation, alpha blocker, retrograde ejaculation
Abstract Views: 563
PDF: 219
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Authors

Muhammad Ilham Fauzan
Department of Urology, Faculty of Medicine, Universitas Brawijaya, Dr. Saiful Anwar General Hospital, Malang, Indonesia.
Besut Daryanto
urobes.fk@ub.ac.id
https://orcid.org/0000-0002-0776-1633
Department of Urology, Faculty of Medicine, Universitas Brawijaya, Dr. Saiful Anwar General Hospital, Malang, Indonesia.
Taufiq Nur Budaya
https://orcid.org/0000-0001-8906-3144
Department of Urology, Faculty of Medicine, Universitas Brawijaya, Dr. Saiful Anwar General Hospital, Malang, Indonesia.
Moh. Anfasa Giffari Makkaraka
https://orcid.org/0000-0003-1179-5366
Andi Djemma Masamba Hospital, South Sulawesi, Indonesia.
Muhammad Fakhri
https://orcid.org/0009-0003-7191-2576
Aceh Singkil Hospital, Aceh, Indonesia.
Ilham Akbar Rahman
https://orcid.org/0000-0002-9469-1943
Department of Urology, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.

Introduction and objectives: Premature Ejaculation (PE) occurs in 31% of men aged 18-59 years, leading to disappointment and avoidance of sexual relations. The current guideline of treatment for PE is Dapoxetine, which possesses several adverse effects causing the limitation of its long-term use. Silodosin, an alpha-1 blocker, has been proposed as a new option for treating PE due to its minimal side effects. Therefore, our study aims to assess the efficacy of silodosin in treating PE.

Materials and methods: This systematic review and meta-analysis was in accordance with Cochrane Handbook guidelines. Comprehensive literature search was conducted in several databases including PubMed, ScienceDirect, and Cochrane Central Register of Controlled Trials. The studies were included if they met the following criteria: (1) Involving premature ejaculation patients; (2) Intervention using silodosin; (3) Comparing placebo or other therapies for PE (4) Outcome includes the Intravaginal Ejaculation Latency Time (IELT) and reported adverse events related to the therapy. Study quality was assessed using Cochrane risk-of-bias criteria. Statistical analysis in this study was performed using Review Manager 5.4

Results: A total of four studies were included in this meta-analysis. Our study showed that patients who received silodosin had a significantly longer IELT compared to control (MD: 132.54, 95% CI 51.51-213.57, p < 0.001). However, patient treated with silodosin also possessed significantly higher risk of adverse event for developing reduced semen ejaculation (OR 10.79, 95% CI 3.46-33.67, p < 0.0001).

Conclusions: Silodosin significantly increased IELT. However, it also reduced semen ejaculation as its drug adverse effect. This result supports the clinical use of silodosin as an alternative treatment for premature ejaculation.

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Citations

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Scopus
Google Scholar
Europe PMC
Parnham A, Serefoglu EC. Classification and definition of premature ejaculation. Transl Androl Urol. 2016; 5:416-23. DOI: https://doi.org/10.21037/tau.2016.05.16
Crowdis M, Leslie SW, Nazir S. Premature Ejaculation. 2023 May 30. Treasure Island, StatPearls Publishing; 2024.
Hatzimouratidis, K. Giuliano, F. Moncada, et al. EAU guidelines on erectile dysfunction, premature ejaculation, penile curvature and priapism. Arnhem, European Association of Urology Guidelines; 2019. Available from: https://d56bochluxqnz.cloudfront.net/media/EAU-Guidelines-on-Male-Sexual-Dysfunction-2019.pdf
Hisasue S. The drug treatment of premature ejaculation. Transl Urol Androl 2016;5:482-6. DOI: https://doi.org/10.21037/tau.2016.06.10
McMahon CG. Dapoxetine: a new option in the medical management of premature ejaculation. Ther Adv Urol. 2012; 4:233-51. DOI: https://doi.org/10.1177/1756287212453866
Bhat GS, Shastry A. Effectiveness of 'on demand' silodosin in the treatment of premature ejaculation in patients dissatisfied with dapoxetine: a randomized control study. Cent Eur J Urol 2016; 69:280-284.
Martin C, Nolen H, Podolnick J, Wang R. Current and emerging therapies in premature ejaculation: Where we are coming from, where we are going. Int J Urol 2017;24:40-50. DOI: https://doi.org/10.1111/iju.13202
Gao J, Zhang X, Su P, et al. Prevalence and impact of premature ejaculation in outpatients complaining of ejaculating prematurely: Using the instruments of intravaginal ejaculatory latency time and patient-reported outcome measures. Int J Impot Res 2014; 26:94-99. DOI: https://doi.org/10.1038/ijir.2013.42
Akin Y, Gulmez H, Ates M, et al. Comparison of alpha blockers intreatment of premature ejaculation: a pilot clinical trial. Iran Red Crescent Med J 2013;15:e13805. DOI: https://doi.org/10.5812/ircmj.13805
Maladkar M, Awate S, Bramhe P. Exploring alpha-blockers as an effective intervention for premature ejaculation. Indian Practit 2024;77:31-36.
Sato Y, Otani T, Amano T, et al. Silodosin versus naftopidil in the treatment of premature ejaculation: A prospective multicenter trial. Int J Urol. 2017; 24:626-631. DOI: https://doi.org/10.1111/iju.13392
Sato Y, Tanda H, Nakajima H, et al. Silodosin and its potential for treating premature ejaculation: a preliminary report. Int J Urol 2012;19:268-72. DOI: https://doi.org/10.1111/j.1442-2042.2011.02941.x
Kobayashi K, Masumori N, Hisasue SI, et al. Inhibition of seminal emission Is the main cause of anejaculation induced by a new highly selective α1A-Blocker in normal volunteers. J Sex Med 2008;5:2185-90. DOI: https://doi.org/10.1111/j.1743-6109.2008.00779.x
Roehrborn CG, Lepor H, Kaplan SA. Retrograde ejaculation induced by silodosin is the result of relaxation of smooth musculature in the male uro-genital tracts and is associated with greater urodynamic and symptomatic improvements in men LUTS secondary to BPH. J Urol 2009;181:694-695. DOI: https://doi.org/10.1016/S0022-5347(09)61944-3
Mohamed Y, Hodeeb I, Saeed M, Hasan M. Effectiveness and safety of silodosin in treatment of premature ejaculation: placebo double blind control study. Egypt J Hosp Med 77:5482-7. DOI: https://doi.org/10.21608/ejhm.2019.60256

How to Cite

Fauzan, M. I., Daryanto, B., Budaya, T. N., Makkaraka, M. A. G., Fakhri, M., & Rahman, I. A. (2024). Promising selective α-1 blocker silodosin as a new therapeutic strategy for premature ejaculation and analysis of its drug adverse effect: A systematic review and meta-analysis of randomized controlled trials. Archivio Italiano Di Urologia E Andrologia, 96(4). https://doi.org/10.4081/aiua.2024.12984
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