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Alfuzosin once daily facilitates return to voiding in patients in acute urinary retention

Created: 26/2/2007

 

Alfuzosin once daily facilitates return to voiding in patients in acute urinary retention
McNeill SA, Hargreave TB; Members of the Alfaur Study Group.
J Urol. 2004 Jun;171(6 Pt 1):2316-20

Objective

  • To confirmed the beneficial effect of the alpha1-blocker alfuzosin for the acute management of acute urinary retention (AUR) related to benign prostate hyperplasia (BPH)
  • To identify factors influencing the success of a trial without catheter (TWOC)

Methods

  • A total of 360 patients presenting with a first episode of spontaneous AUR related to BPH underwent emergency catheterization and were then randomly and blindly assigned to receive 10 mg alfuzosin once daily or placebo at a ratio of 2:1 for 3 days
  • The primary efficacy criterion of this large study was the rate of successful TWOC within 24 hours after catheter removal
  • The influence of factors such as age, urine retention volume, fluid consumption, constipation and urinary tract infection on TWOC outcome was also assessed

Results

  • Successful TWOC was recorded in 61.9% of the 236 patients treated with alfuzosin vs 47.9% of the 121 receiving placebo (p = 0.012)
  • Elderly patients (65 years or older) and patients with a drained volume of 1000 ml or greater had significantly greater chances of TWOC failure (success vs failure OR 0.309, 95% CI 1.182 to 0.514 and OR 0.361, 95% CI 0.225 to 0.571, respectively) (However, 10 mg alfuzosin once daily almost doubled the likelihood of successful TWOC (OR 1.98, 95% CI 1,226 to 3,217) in such cases)
  • Alfuzosin (10 mg) once daily was well tolerated

Conclusions

  • Alfuzosin (10 mg) once daily significantly improved the rate of successful TWOC in patients with AUR related to BPH, even in elderly patients and those with a large drained volume who were at increased risk for TWOC failure
  • This should contribute to decrease the morbidity and mortality associated with emergency surgery and avoid the discomfort and potential morbidity associated with an in situ catheter

ArticleDate:20070226
SiteSection: Article
 
   
    
                                            



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