Effects of silodosin on sexual function - realistic picture from the everyday clinical practice

The treatment with alpha 1-blockers in patients complaining of lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) is associated with potential adverse events (AEs), thus including ejaculatory dysfunction (EjD). We sought to assess the effects of a 3-month course of silodosin 8 mg daily dosing on sexual functioning, mainly including ejaculation and orgasm, in a cohort of 100 consecutive sexually active men in the real-life setting. Patients completed the International Index of Erectile Function-Orgasmic Function (IIEF-OF) domain and the International Prostate Symptom Score (IPSS) both at baseline and at survey. Likewise, patients completed a 16-item self-administered questionnaire with closed questions also including specific questions regarding treatment-related adverse events on sexual functioning. Rates and predictors of OF impairment and drug discontinuation were investigated. At survey, silodosin resulted highly effective in improving IPSS-total and subscales (all p < 0.01). Anejaculation, hypospermia, reduced or absent orgasmic feeling, low sexual desire and erectile dysfunction were subjectively reported by 48 (48%), 23 (23%), 11 (11%), 6 (6%), 7 (7%) and 11 (11%) patients respectively. Overall, a reduction in IIEF-OF domain score was observed in 64 (64%) patients. Patients with decreased IIEF-Q9 and/or IIEF-Q10 scores were significantly younger than those without any decrease (p = 0.02). Of all, only 7% of the patients discontinued silodosin because of anejaculation. Silodosin confirms to be highly effective in patients with LUTS/BPH; of them, almost 70% report either anejaculation or hypospermia, with a concomitant OF impairment in 17% of the patients. Younger patients showed higher rates of a concomitant impairment of ejaculation and OF. Overall, anejaculation caused drug discontinuation in 7% of the patients.