Anterior cutaneous nerve entrapment syndrome (ACNES) is a nerve entrapment condition that causes chronic pain of the abdominal wall. It occurs when nerve endings of the lower thoracic intercostal nerves (7–12) are entrapped in abdominal muscles, causing a severe localized nerve (neuropathic) pain that is usually experienced at the front of the abdomen. ACNES is frequently overlooked and unrecognized, although the incidence is estimated to be 1:2000 patients.The relative unfamiliarity with this condition often leads to significant diagnostic delays and misdiagnoses, often resulting in unnecessary diagnostic interventions and futile procedures. Physicians often misdiagnose ACNES as irritable bowel syndrome or appendicitis as symptoms of the condition are not unique to this syndrome. Signs and symptoms
Affected individuals typically experience limited relief from standard pain relieving medication, with the exception of some neuroleptic agents. Patients frequently experience pseudovisceral phenomena or symptoms of altered autonomic nervous system function including nausea, bloating, abdominal swelling, loss of appetite with consecutively lowered body weight or an altered defecation process.Pain is typically related to tensing the abdominal wall muscles, so any type of movement is prone to aggravate pain. Lying quietly can be the least painful position. Most patients report that they cannot sleep on the painful side. Diagnosis
Once ACNES is considered based on the patients history, the diagnosis can be made via a thorough physical examination: looking for a painful spot, which worsens by tensing the abdominal muscles with lifting the head and straightened legs (Carnetts sign).
(Sources are contradictory on this.) History
Silodosin received its first marketing approval in Japan in May 2006, under the brand name Urief, which is jointly marketed by Kissei Pharmaceutical and Daiichi Sankyo. Kissei licensed the US, Canadian, and Mexican rights for silodosin to Watson Pharmaceuticals (now Allergan) in 2004. AbbVie absorbed Allergan in 2019. The United States Food and Drug Administration and Health Canada approved silodosin under the brand name Rapaflo on 9 October 2008 and 11 January 2011, respectively. Society and culture
Brand names
Other brand names include Urorec (European Union, Australia, Russia), Niksol (Croatia), Silorel (Jamaica),  
SiloSoft Sildoo, Silodal Silofast (India), Thrupas (South Korea), and Flopadex (Egypt). Research
As α1A adrenoceptor antagonists are being investigated as a means to male birth control due to their ability to inhibit ejaculation but not orgasm, a trial with 15 male volunteers was conducted. While silodosin was completely efficacious in preventing the release of semen in all subjects, 12 out of the 15 patients reported mild discomfort upon orgasm. The men also reported the psychosexual side effect of being strongly dissatisfied by their lack of ejaculation. References
External links
"Silodosin". Drug Information Portal. U.S. National Library of Medicine.