title: Medical treatment for urinary retention in rehabilitating elderly women: is it necessary?
abstract: OBJECTIVE
  It is unclear whether medical treatment of elderly women with acute urinary retention in geriatric rehabilitation centers affects the recovery rate. The aims of the present study were to assess the rate of spontaneous recovery from urinary retention in elderly women in rehabilitation centers and to determine whether medical treatment with a adrenergic receptor blockers (a blockers) is effective in resumption of urination in this population.
  
  
  METHODS
  We surveyed 84 elderly women with urinary retention, admitted to a geriatric rehabilitation center between September 1998 and March 2000. Most had undergone orthopedic surgeries. Post-voiding urine residual (PVR) was measured 3 days after an acute episode of urinary retention. PVR of 250 mL and below was the desirable outcome. Patients with PVR over 250 mL were randomly assigned to two groups, placebo vs Doxazosin. Medication doses in both groups were increased every 3 days and catheterization was used until a desirable outcome was achieved.
  
  
  RESULTS
  Seventy-eight out of the 84 patients entered the study, of whom 48 (62%) recovered spontaneously prior to initiation of medical treatment. Of the remaining 30, 7 patients dropped out and 23 began medical treatment. Twelve women recovered (a similar rate occurred in the placebo and Doxazosin groups), and 11 did not. The study was terminated due to the high rate of spontaneous recovery and because it became clear from the initial results that Doxazosin had no beneficial effect over placebo in the treatment of urinary retention. Diabetes and poor functional status were found to be prognostic factors for recovery failure.
  
  
  CONCLUSIONS
  Most elderly women with urinary retention in geriatric rehabilitation centers will probably recover spontaneously. Alpha blockers appear to have no beneficial effect in this population.
authors.affiliation: Beit Rivka' Geriatric Rehabilitation Center Day Hospital, Petach Tikva, Israel. uritamar@netvision.net.il
authors.forename: Avital
authors.initials: A
authors.lastname: Hershkovitz
authors.forename: Dimitri
authors.initials: D
authors.lastname: Manevitz
authors.forename: Yichayaou
authors.initials: Y
authors.lastname: Beloosesky
authors.forename: Gabriel
authors.initials: G
authors.lastname: Gillon
authors.forename: Shai
authors.initials: S
authors.lastname: Brill
mesh_terms: D000208:Acute Disease; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D017292:Doxazosin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D011184:Postoperative Period; D012307:Risk Factors; D019564:Unnecessary Procedures; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000188:drug therapy* / Q000453:epidemiology / Q000534:rehabilitation
chemical_list: D000317:Adrenergic alpha-Antagonists; D017292:Doxazosin