Expert opinion on the prescription practice of silodosin for treating benign prostatic hyperplasia patients in Indian clinical settings

Background: The effectiveness and safety of silodosin compared to other drugs have been the subject of numerous studies to date, although the findings are debatable. So, this study aims to gather expert opinion on the prescription practice of silodosin for men with lower urinary tract symptoms leading to benign prostatic hyperplasia. Methods: This cross-sectional, multiple-response questionnaire-based survey, included experts from various states across India with expertise in treating BPH. The study questionnaire, comprising 25 survey items on the management of BPH utilizing silodosin (8 mg) and other drug combinations to gather data via email or an online survey platform. Results: Out of the 55 experts, 76% identified non-specific urinary tract infections as the most prevalent concomitant ailment in BPH patients. The majority of the experts (89.09%) recommended silodosin medication for these patients, and about 58% reported that patients might need to continue silodosin medication for three months. Another major benefit reported was its high selectivity for alpha 1A receptors (34.55%). However, 47% of experts reported retrograde ejaculation as a side effect, and 27% reported orthostatic hypotension. According to nearly 80% of responders, patients with BPH can use silodosin in combination with mirabegron (25/50 mg). A combination of silodosin and dutasteride was favoured by 67% of responders for BPH patients with acute urine retention. Conclusions: The expert consensus has highlighted silodosin as an effective treatment option for LUTS in men with BPH in Indian settings. Silodosin and dutasteride combination were recommended by specialists for BPH patients with acute urine retention.