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

  • V Chandramohan Government Vellore Medical College, Vellore, Tamil Nadu, India
  • N Narayanamoorthy Government Vellore Medical College, Vellore, Tamil Nadu, India
Keywords: Acute urinary retention, Benign prostatic hyperplasia, Management, Tamsulosin, Trial without catheter


ntroduction: 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.

Author Biographies

V Chandramohan, Government Vellore Medical College, Vellore, Tamil Nadu, India

Assistant Professor, Department of Urology,

N Narayanamoorthy, Government Vellore Medical College, Vellore, Tamil Nadu, India

Assistant Professor, Department of Urology,


1. Caine M, Pfau A, Perlberg S. The use of alpha-adrenergic blockers in
benign prostatic obstruction. Br J Urol 1976;48:255-63.
2. Thomas K, Oades G, Taylor-Hay C, Kirby RS. Acute urinary retention:
What is the impact on patients’ quality of life? BJU Int 2005;95:72-6.
3. Roehrborn CG, Lukkarinen O, Mark S, Siami P, Ramsdell J, Zinner N,
et al. Long-term sustained improvement in symptoms of benign protatic
hyperplasia with the dual 5areductase inhibitor dutasteride: Results of
4-year studies. BJU Int 2005;96:572-7.
4. Breum L, Klarskov P, Munck LK, Nielsen TH, Nordestgaard AG.
Significance of acute urinary retention due to infravesical obstruction.
Scand J Urol Nephrol 1982;16:21-4.
5. Holtgrewe HL, Mebust WK, Dowd JB, Cockett AT, Peters PC, Proctor C.
Transurethral prostatectomy: Practice aspects of the dominant operation in
American urology. J Urol 1989;141:248-53.
6. Roehrborn CG. Epidemiology of acute urinary retention in benign prostatic
hyperplasia. Rev Urol 2001;3:187-92.
7. Chen JS, Chang CH, Yang WH, Kao YH. Acute urinary retention increases
the risk of complications after transurethral resection of the prostate:
A population-based study. BJU Int 2012;110:E896-901.
8. Diane K. Managing urinary retention in the acute care setting. Newman
9. Elterman DS, Barkin J, Kaplan SA. Optimizing the management of benign
prostatic hyperplasia. Ther Adv Urol 2012;4:77-83.
10. Lucas MG, Stephenson TP, Nargund V. Tamsulosin in the management of
patients in acute urinary retention from benign prostatic hyperplasia. BJU
Int 2005;95:354-7.
11. Agrawal MS, Yadav A, Yadav H, Singh AK, Lavania P, Jaiman R.
Prospective randomized study comparing the efficacy and safety ofalfuzosin and tamsulosin in patients suffering from acute urinary
retention caused by benign prostatic hyperplasia (BPH). Indian J Urol
12. Hua LX, Wu HF, Sui YG, Chen SG, Xu ZQ, Zhang W, et al. Tamsulosin
in the treatment of benign prostatic hyperplasia patients with acute urinary
retention. Zhonghua Nan Ke Xue 2003;9:510-1.
13. McConnel JD, Roehrborn CG, Bautista OM, Andriole GL Jr, DixonCM. Medical therapy of prostatic symptoms study research group - The
long-term effect of doxazosin, finasteride, and combination therapy on
the clinical progression of benign prostatic hyperplasia. N Engl J Med
14. Fitzpatrick JM, Desgrandchamps M, Adjali K. Management of acute
urinary retention: A worldwide survey of 6074 men with benign prostatic
hyperplasia. BJU Int 2011;10:88-95.