Effects of silodosin and naftopidil on the distal ureter and cardiovascular system in anesthetized dogs: comparison of potential medications for distal ureteral stone passage.

Abstract

PURPOSE: We compared the effects of the selective alpha(1A)-adrenoceptor antagonist silodosin and the selective alpha(1D)-adrenoceptor antagonist naftopidil on intraureteral pressure in anesthetized dogs and evaluated their uroselectivity. MATERIALS AND METHODS: Using anesthesia the effects of silodosin and naftopidil were evaluated by the phenylephrine induced increase in intravesical ureteral pressure and on blood pressure. Each drug was administered intravenously in progressively increasing doses. The dose of each alpha(1)-adrenoceptor antagonist at which mean blood pressure was decreased by 15% (ED(15)) and the dose at which the phenylephrine induced increase in intravesical ureteral pressure was suppressed by 50% (ID(50)) were measured and uroselectivity was calculated as ED(15)/ID(50). RESULTS: Silodosin dose dependently suppressed the phenylephrine induced increase in intravesical ureteral pressure (ID(50) 2.5 microg/kg) but decreased mean blood pressure only at higher doses (ED(15) 143.4 microg/kg). In contrast, naftopidil decreased mean blood pressure (ED(15) 280.7 microg/kg) at the same doses as those that decreased the phenylephrine induced increase in intravesical ureteral pressure (ID(50) 225.1 microg/kg). Silodosin uroselectivity was markedly higher than that of naftopidil (58.6 vs 1.3). CONCLUSIONS: Results suggest that a selective alpha(1A)-adrenoceptor antagonist such as silodosin may facilitate distal ureteral stone passage at nonhypotensive doses.