Comparison of the Efficacy of Tamsulosin and Placebo in the Management of Acute Urinary Retention Secondary to Benign Prostatic Hyperplasia Undergoing Trial without Catheter until Definitive Therapy
Introduction: Acute urinary retention (AUR) is one of the most significant, uncomfortable and inconvenient events in the natural history
of benign prostatic hyperplasia (BPH). The immediate treatment is bladder decompression using urethral or suprapubic catheterization.
Aim: In this study, the effect of tamsulosin has been evaluated in the temporary management of AUR by increasing the rate of
successful trial without catheter (TWOC) until definitive therapy.
Materials and Methods: This prospective randomized study was conducted in tamsulosin Group A/placebo Group B. Patients
with AUR after catheterization were given once daily dose of tamsulosin 0.4 mg for 4 days. Placebo group, patients with AUR
after catheterizations were given 4 days of vitamin tablets. Success criteria for TWOC; trial without the catheter is considered
successful if the patient passes urine more than 100 ml with a PVR of <200 ml either in ultrasonography or actually measured
by inserting an interferential therapy.
Results: In Group A, the total success rate of TWOC is 59.5% and the failure rate is 40.5%. In Grade 1 prostate, 11 of 12 had
successful TWOC (91.66%) with tamsulosin. The success rate of TWOC in Group B is 32.4%, and TWOC is more successful
in patients with Grade 1 prostate (6 of 10).
Conclusion: Prostate size has the statistically significant influence on trial without the catheter. Patients with larger prostate
have more chances of failure in the trial without the catheter in both groups. However, tamsulosin increases the success rate
of trial without the catheter in patients with the larger prostate.
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