Does sildenafil enhance the effect of tamsulosin in relieving acute urinary retention?

Sharifi, Seyed Hossein Hosseini; Mokarrar, Mohsen Heidari; Khaledi, Flora; Yamini-Sharif, Reyhaneh; Lashay, Alireza; Soltani, Mohammad Hossein

doi:10.1590/s1677-5538.ibju.2014.03.11

Cited by 11 publications

(13 citation statements)

References 26 publications

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“…In contrast, no benefit has been revealed with the use of the nonselective a1-blocker doxazosin, and addition of sildenafil to tamsulosin does not offer additional benefit compared with tamsulosin monotherapy. However, these studies are underpowered; CoE is very low and therefore no definite conclusions can be drawn for these comparisons [36,37]. Pooled results indicate that alfuzosin and tamsulosin monotherapy provide significantly higher successful TWOC rates than placebo with rare adverse events.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 21 studies (18 RCTs [6][7][8][9][10][11][31][32][33][34][35][36][37][38][39][40][41][42] and three prospective comparative studies [43][44][45]) were included. Fig.…”

Section: Evidence Synthesismentioning

confidence: 99%

“…4) but similar rates to alfuzosin (51/87 [59%] vs 45/84 [54%]; OR 1.28, 95% CI 0.68 to 2.41; participants = 171; studies = 2; I 2 = 0%; very low CoE). Tamsulosin was also compared with tamsulosin/alfuzosin combination in one RCT [33] and tamsulosin/sildenafil combination in another RCT [37]. No difference between monotherapy and tamsulosin/alfuzosin combination was detected regarding successful TWOC rates: 11/35 (31%) versus 14/35 (40%); OR 0.69, 95% CI 0.26 to 1.84; participants = 70; studies = 1; very low CoE.…”

Section: Evidence Synthesismentioning

confidence: 99%

“…Most common adverse events in the combination arm included dizziness, headache, and retrograde ejaculation, which were not significantly higher than those in the monotherapy arm [33]. The tamsulosin/sildenafil combination was also similar to monotherapy regarding successful TWOC rates: 41/50 (82%) versus 37/51 (73%); OR 1.46, 95% CI 0.66 to 3.25; participants = 101; studies = 1; very low CoE [37]. Three-day versus 7-d tamsulosin treatment for AUR was compared in one RCT [32] E U R O P E A N U R O L O G Y X X X ( 2 0 1 8 ) X X X -X X X between arms: 48/61 (79%) versus 52/59 (88%); OR 0.58, 95% CI 0.22 to 1.52; participants = 120; studies = 1; very low CoE [41].…”

Section: Evidence Synthesismentioning

confidence: 99%

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Management of urinary retention in patients with benign prostatic obstruction: A systematic review and meta-analysis

Karavitakis¹,

Kyriazis²,

Omar³

et al. 2019

European Urology Supplements

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E U R O P E A N U R O L O G Y X X X ( 2 0 1 8 ) X X X -X X X a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e u r o p e a n u r o l o g y . c o m AbstractContext: Practice patterns for the management of urinary retention (UR) secondary to benign prostatic obstruction (BPO; UR/BPO) vary widely and remain unstandardized. Objective: To review the evidence for managing patients with UR/BPO with pharmacological and nonpharmacological treatments included in the European Association of Urology guidelines on non-neurogenic male lower urinary tract symptoms. Evidence acquisition: Search was conducted up to April 22, 2018, using CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform. This systematic review included randomized controlled trials (RCTs) and prospective comparative studies. Methods as detailed in the Cochrane handbook were followed. Certainty of evidence (CoE) was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Evidence synthesis: Literature search identified 2074 citations. Twenty-one studies were included (qualitative synthesis). The evidence for managing patients with UR/ BPO with pharmacological or nonpharmacological treatments is limited. CoE for most outcomes was low/very low. Only a1-blockers (alfuzosin and tamsulosin) have been evaluated in more than one RCT. Pooled results indicated that a1-blockers provided significantly higher rates of successful trial without catheter compared with placebo [alfuzosin: 322/540 (60%) vs 156/400 (39%) (odds ratio {OR} 2.28, 95% confidence interval {CI} 1.55 to 3.36; participants = 940; studies = 7; I 2 = 41%; low CoE); tamsulosin: 75/158 (47%) vs 40/139 (29%) (OR 2.40, 95% CI 1.29 to 4.45; participants = 297; studies = 3; I 2 = 30%; low CoE)] with rare adverse events. Similar rates were achieved with tamsulosin or alfuzosin [51/87 (59%) vs 45/84 (54%) (OR 1.28, 95% CI 0.68 to 2.41;

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Section: Discussionmentioning

confidence: 99%

“…A total of 21 studies (18 RCTs [6][7][8][9][10][11][31][32][33][34][35][36][37][38][39][40][41][42] and three prospective comparative studies [43][44][45]) were included. Fig.…”

Section: Evidence Synthesismentioning

confidence: 99%

Section: Evidence Synthesismentioning

confidence: 99%

Section: Evidence Synthesismentioning

confidence: 99%

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Management of urinary retention in patients with benign prostatic obstruction: A systematic review and meta-analysis

Karavitakis¹,

Kyriazis²,

Omar³

et al. 2019

European Urology Supplements

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“…Although majority of therapies have been applied to treat urinary retention, including medication [5][6], bladder catheterization [7], physiotherapy [8]. However, all these approaches exhibited some disadvantages or side effects [9][10].…”

Section: Introductionmentioning

confidence: 99%

Electroacupuncture at the Four Abdominal and Sacral Acupoints for Urinary Retention after Spinal Cord Injury: Study Protocol for a Randomized Controlled Trial

Liu¹,

Yu²,

Kuang

et al. 2020

Preprint

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Background：Urinary retention is a general and serious refractory complication after spinal cord injury (SCI). However, effective therapeutic approaches remain limited. Previous clinical and animal research have clarified that acupuncture could be beneficial to the recovery of bladder function, however, most of the previous trials are of low quality and high-quality studies are still necessary.Methods: Here, we conduct a study design and protocol of a randomized, blinded, controlled study to evaluate the efficacy and safety of electroacupuncture at the “Four Abdominal and Sacral Acupoints” for urinary retention after SCI. A total of 90 patients with residual urine above 300ml will be recruited in the trial and randomized into treatment group or control group. Patients in the treatment group will receive Electroacupuncture at the “Four Abdominal and Sacral Acupoints” combined with conventional treatment while patients in the control group will receive conventional treatment alone for 4 weeks. The primary outcomes are changes of residual urine volume at baseline, after the final treatment and 4 weeks after the final treatment. The secondary outcome measures will be the proportions of participants with residual urine decline≥50% and efficacy rate after 4 weeks’ treatment, as well as the proportion of patients with catheterization, Short-Form Health Survey Questionnaire (SF-36) and the incidence of symptomatic urinary tract infection at baseline, after the final treatment and 4 weeks after the final treatment. The safety will also be assessed by monitoring the incidence of adverse events and changes in vital signs during the study.Discussion：Results from this trial will significantly support the application of electroacupuncture in the recovery of bladder function after SCI. If found to be effective and safe, electroacupuncture will be a valuable complementary option for patients with urinary retention after SCI.Trial registration: Chinese Clinical Trial Registry: ChiCTR 1900022089. Registered on 24 March 2019, http://www.chictr.org.cn/showproj.aspx?proj=37161.

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Immediate or delayed trial without catheter in acute urinary retention in males: A systematic review

Christensen,

Skow,

Flottorp

et al. 2024

BJUI Compass

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ObjectiveTo compare the success of establishing spontaneous micturition following immediate trial without catheter (TWOC) to delayed TWOC in males catheterized for acute urinary retention.Materials and methodsIn this systematic review, we included studies reporting success rates of immediate TWOC or delayed TWOC (≤30 days) among males ≥18 years of age catheterized for acute urinary retention. We excluded studies on suprapubic catheterization, postoperative/perioperative catheterization and urinary retention related to trauma. We searched the following databases: MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Open Grey and Clinicaltrials.gov. The search was concluded on 30 November 2022. There were no restrictions on language or publication date. Risk of bias was assessed using the ROB 2.0 and ROBINS‐I tools. We did random‐effects restricted maximum likelihood model meta‐analyses. Certainty of evidence was assessed using GRADE.ResultsWe included 61 studies. In two randomized controlled trials (RCTs), both with some concerns for risk of bias, including in total 174 participants, the relative success rate was 1.22 (95% CI 0.84–1.76) favouring delayed TWOC. In two comparative cohort studies, both with serious risk of bias, including 642 participants, the relative success rate was 1.18 (0.94–1.47) favouring delayed TWOC. One study was excluded from this meta‐analysis because of critically low quality. Four studies reporting success rates for cohorts with immediate TWOC, all with serious risk of bias, including 409 participants, had an overall success rate of 47% (29–66). Fifty‐two studies reporting success rates for cohorts with delayed TWOC, all with serious risk of bias, including 12 489 participants, had an overall success rate of 53% (49–56). The certainty of the evidence was considered low for the RCTs and very low for the rest.ConclusionThere was a limited number of appropriately designed studies addressing the research question directly. The evidence favours neither approach.

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Does sildenafil enhance the effect of tamsulosin in relieving acute urinary retention?

Cited by 11 publications

References 26 publications

Management of urinary retention in patients with benign prostatic obstruction: A systematic review and meta-analysis

Management of urinary retention in patients with benign prostatic obstruction: A systematic review and meta-analysis

Electroacupuncture at the Four Abdominal and Sacral Acupoints for Urinary Retention after Spinal Cord Injury: Study Protocol for a Randomized Controlled Trial

Immediate or delayed trial without catheter in acute urinary retention in males: A systematic review

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