Effectiveness of tamsulosin in prevention of post-operative urinary retention: a randomized double-blind placebo-controlled study

Abstract

ARTICLE INFO ______________________________________________________________ ______________________Purpose: Urinary retention is one of the most common complications contributing to surgical procedures. Recent studies have shown the benefits of alpha-adrenergic blockers in preventing post-operative urinary retention (POUR). The aim of this prospective study was to compare the prophylactic effect of tamsulosin with placebo on postoperative urinary retention. Materials and Methods:In this randomized placebo controlled, clinical trial, 232 male patients aged 18 to 50 years old admitted to Razi University Hospital for varicocelectomy, inguinal herniorrhaphy, and scrotal surgery were randomly assigned to receive either three doses of 0.4mg tamsulosin (n = 118) or placebo (n = 114), 14 and 2 hours before, and 10 hours after surgery. Patients were closely monitored for the development of urinary retention 24 hours after surgical intervention. The primary endpoint was to investigate the effect of tamsulosin in prevention of post-operative urinary retention during the first 24 hours after surgical intervention. Collected data were analyzed using SPSS software version 18 and the P < 0.05 was considered statistically significant. Results: One hundred and eighteen patients were included in tamsulosin arm and 114 in placebo arm. POUR in patients who received tamsulosin was significantly lower than placebo, as 5.9% of the patients treated with tamsulosin and 21.1% placebo group, reported urinary retention following surgery (P = 0.001). No serious adverse effects were seen in both groups.Conclusions: This study suggests that short perioperative treatment with tamsulosin can reduce the incidence of urinary retention and the need for catheterization after varicocelectomy, inguinal herniorrhaphy, and scrotal surgery.

Systematic review of interventions for the prevention and treatment of postoperative urinary retention

“…After removal of duplicate records, 6415 reports were identified of which 48 studies (5644 participants) were included in the review ( Fig . ).…”

“…Of the 48 included trials, ten , , , , were considered to be at low risk of bias; eight of these evaluated pharmacological interventions and two evaluated non‐pharmacological interventions. Eleven , , , , were judged at high risk of bias; these studies evaluated pharmacological (7 studies) and non‐pharmacological (3) interventions for the prevention of PO‐UR, and a pharmacological intervention (1 study) for the treatment of PO‐UR.…”

“…0·14 to 0·41; I 2 = 57·6 per cent; 12 trials). Studies compared tamsulosin (5 trials) , , , phenoxybenzamine (3) , , prazosin (3) , , alfuzosin (1 trial) and dibenzyline (1 trial) with placebo or no treatment. Two of the phenoxybenzamine trials were restricted to women.…”

Preventive effect of tamsulosin on postoperative urinary retention in neurosurgical patients

“…[1915161820] Mohammadi-Fallah et al . followed 80 males who underwent elective inguinal herniorrhaphy.…”

“…followed 232 male patients aged 18 to 50 years of age undergoing varicocelectomy, inguinal herniorrhaphy, and scrotal surgery. [16] They were randomized to receive either three doses of 0.4 mg tamsulosin ( N = 118) or placebo ( N = 114). POUR developed in 5.9% of the patients receiving tamsulosin versus 21.1% for control patients ( P = 0.001).…”