[Doxazosin in the gastrointestinal therapeutic system (GITS) formulation and trial without catheter after acute urinary retention due to BPH. Dose increase action on recovery effect].
OBJECTIVE
Prospective and randomised study to assess the effectiveness of doxazosin in sustained release formulation in Acute Urinary Retention (AUR) treatment due to benign prostatic hyperplasia (BPH).


METHODS
The trial was carried out with a cohort of 40 males who had all suffered their first attack of AUR caused by BPH. Twenty were randomly selected and treated for 7 days with 4 mg of sustained release doxazosin before removing the catheter. The patients not treated that could not spontaneously urinate were also administered 4 mg of doxazosin. Finally, all the patients that still had a catheter due to unsuccessful removal were treated with 8 mg of doxazosin and the percentage of patients responding to treatment was assessed. The predictive value of the response to treatment for age, IPSS, QoL, retained urine volume, prostate volume and the evolution time of the prostratism was determined by means of logistic regression analysis.


RESULTS
82.5% of the patients (33/40) could urinate after removal of the catheter. 84.8% (28/33) were treated with doxazosin (21 with 4 mg and 7 with 8 mg). In the first attempt at removal, 60% of the patients (12/20) treated with 4 mg of doxazosin could spontaneously urinate, while only 25% (5/20) of those not treated, p=0.02. Similarly, 60% of the patients (9/15) treated with 4 mg of doxazosin in the second attempt could spontaneously urinate. Fifty per cent (7/14) of the patients still with a catheter, after the treatment with 4 mg of doxazosin, could urinate with 8 mg. In the logistic regression analysis, none of the variables analyzed allowed us to predict the response to the treatment.


CONCLUSIONS
The treatment for 7 days with 4 mg of sustained release doxazosin shows greater success when removing the catheter after suffering AUR due to BPH. With this treatment, 60% of the patients could spontaneously urinate again. By increasing the dose to 8 mg, the catheter can be removed in half the patients that did not initially respond. Before removing the catheter it is not possible to predict which patients would be able to spontaneously urinate.
Lorente Garín
J A
JA
Servicio y Cátedra de Urología, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona.
Cañis Sánchez
D
D
Arango Toro
O
O
Bielsa Gali
O
O
Cortadellas Angel
R
R
Gelabert Mas
A
A
D000208:Acute Disease; D000368:Aged; D017292:Doxazosin / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000150:complications*; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000188:drug therapy* / Q000209:etiology* / Q000628:therapy
D017292:Doxazosin