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Newer Medications for Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: A Review [Internet]

To assess the efficacy, comparative effectiveness, and adverse effects of newer drugs to treat lower urinary tract symptoms (LUTS) attributed to benign prostatic hyperplasia (BPH).

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: May 2016
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Silodosin for the treatment of clinical benign prostatic hyperplasia: safety, efficacy, and patient acceptability

α1-Adrenergic receptor antagonists are commonly used to treat male lower urinary tract symptoms and benign prostatic hyperplasia (BPH). We performed a literature search using PubMed, Medline via Ovid, Embase, and the Cochrane Library databases to identify studies on the treatment of BPH by silodosin. Silodosin is a novel α1-adrenergic receptor antagonist whose affinity for the α1A-adrenergic receptor is greater than that for the α1B-adrenergic receptor. Therefore, silodosin does not increase the incidence of blood pressure-related side effects, which may result from the inhibition of the α1B-adrenergic receptor. Patients receiving silodosin at a daily dose of 8 mg showed a significant improvement in the International Prostate Symptom Score and maximum urinary flow rate compared with those receiving a placebo. Silodosin also improved both storage and voiding symptoms, indicating that silodosin is effective, even during early phases of BPH treatment. Follow-up extension studies performed in the United States, Europe, and Asia demonstrated its long-term safety and efficacy. In the European study, silodosin significantly reduced nocturia compared to the placebo. Although retrograde or abnormal ejaculation was the most commonly reported symptom in these studies, only a few patients discontinued treatment. The incidence of adverse cardiovascular events was also very low. Evidence showing solid efficacy and cardiovascular safety profiles of silodosin will provide a good solution for the treatment of lower urinary tract symptoms associated with BPH in an increasingly aging society.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

The efficacy and safety of silodosin in treating BPH: a systematic review and meta-analysis

PURPOSE: Pharmacological therapy is typically the first-line treatment for patients with benign prostatic hyperplasia (BPH). We carried out a systematic review and meta-analysis to assess the efficacy and safety of silodosin for treating BPH.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Systematic review and meta-analysis of randomized controlled trials evaluating silodosin in the treatment of non-neurogenic male lower urinary tract symptoms suggestive of benign prostatic enlargement

PURPOSE: To perform a systematic review and meta-analysis of randomized clinical trials (RCTs) reporting the efficacy and safety of silodosin in the treatment of non-neurogenic male LUTS suggestive of benign prostatic enlargement.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

A meta-analysis of efficacy and safety of the new alpha 1A-adrenoceptor-selective antagonist silodosin for treating lower urinary tract symptoms associated with BPH.

BACKGROUND: Recently several clinical trials have focused on the efficacy and safety of silodosin, a new, highly selective α1A-blocker. We tried to verify silodosin's superiority to placebo and non-inferiority to tamsulosin in treating patients with lower urinary tract symptoms (LUTS) associated with BPH.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

A pooled analysis of individual patient data from registrational trials of silodosin in the treatment of non-neurogenic male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH)

OBJECTIVE: To evaluate the efficacy and safety of silodosin in a pooled analysis based on individual patients data from three randomised controlled trials (RCTs) comparing silodosin and placebo.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Silodosin is effective for treatment of LUTS in men with BPH: a systematic review

The review concluded that silodosin was effective for lower urinary tract symptoms in men with benign prostatic hyperplasia (non-malignant prostate enlargement), but that the incidence of retrograde ejaculate was higher than with placebo or tamsulosin. The authors appropriately acknowledged that the small volume of short-term evidence of unknown quality may weaken the reliability of their findings, which seems appropriate.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Alpha blocker treatment for men to increase chances to have urinary catheter successfully removed

Acute urinary retention in men is a medical emergency characterised by the sudden and often painful inability to pass urine. There are many known causes including prostate obstruction (because of enlargement of the prostate or cancer), urethral strictures (a narrowing of the urethra due to scar tissue), urine infection, constipation and neurological conditions. A narrow drainage tube (urinary catheter) is temporarily inserted into the bladder through the penis to allow drainage of urine. Once the catheter is removed, some men fail to pass urine again and need to be re‐catheterised. In these men, continued use of catheters or prostate surgery are the standard treatment options. Catheters are associated with risks such as infection and can harm quality of life. Measures for increasing the rate of successful catheter removal, that is, enabling patients to urinate spontaneously again, are therefore potentially beneficial. Alpha blockers (for example tamsulosin, alfuzosin) are a group of drugs known to have positive effects on urinary symptoms such as poor urinary flow. It is believed that their relaxing effect on the prostate may also increase the chance to void again after catheter removal. This review evaluated the evidence available to support this practice.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Chronic Urinary Retention: Comparative Effectiveness and Harms of Treatments [Internet]

To determine the effectiveness and comparative effectiveness of treatments for chronic urinary retention (CUR), also termed partial or persistent urinary retention or incomplete bladder emptying, in adults.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: September 2014
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Urinary Incontinence in Neurological Disease: Management of Lower Urinary Tract Dysfunction in Neurological Disease

The guideline covers adults and children (from birth) with lower urinary tract dysfunction resulting from neurological disease or injury.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: August 2012
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Impact of medical treatments for male lower urinary tract symptoms due to benign prostatic hyperplasia on ejaculatory function: a systematic review and meta-analysis

INTRODUCTION: Several drugs, currently used to treat lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH), can be associated with bothersome sexual side effects, including ejaculatory dysfunction (EjD).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

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