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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

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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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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