Urological impact of flozins (SGLT2 inhibitors): an EAU Endourology review of risks, side effects and clinical considerations.

Purpose of review: Sodium-glucose cotransporter 2 inhibitors (SGLT2i), also known as flozins, are one of the modern oral antidiabetic drugs. Currently, there are sufficient number of studies devoted to the effect of flozins on various genitourinary disorders, confirming their multifaceted positive and side effects. Thus, the purpose of this review is to analyze the current literature for an up-to-date definition of the role of these drugs in urological practice, prospects for their further study, and side effects that urologists need to remember when treating patients with T2DM taking flozins.

Recent findings: Flozins (SGLT2i) are not linked to urological cancer risk, and might even lower the risk by disrupting tumor metabolism and cell cycle. Despite causing glucosuria, the resulting effect of Flozins is antilithogenic, which may be promising for patients with type 2 diabetes mellitus (T2DM) and kidney stone disease, especially regarding risk of recurrence. While the overall risk of UTI is not increased, flozins significantly increase the risk of genital mycotic infections. Flozins can worsen LUTS due to their diuretic action.

Summary: Current results of studies on the use of flozins in patients with T2DM are promising for different spectrums of genitourinary diseases caused by different pathogenetic mechanisms. However, we need future clinical trials with specific drugs and comparisons to get trustworthy results about how helpful flozins are for these patients and whether they can be used in urology.