Long term follow up of men with Alfuzosin who voided successfully following acute urinary retention*.
BACKGROUND
Acute urinary retention (AUR) is one of the commonest causes of admission in urology ward and successful voiding with alpha-blockers has been reported. However, long-term efficacy of Alfuzosin, following an episode of AUR is lacking. This is a continuation of our earlier reported study. We report the results of a 4 year follow-up on patients who were on Alfuzosin SR 5 mg BD, following resumption of voiding after an episode of AUR.


METHODS
A total of 33 patients voided successfully following AUR in our original study. These patients continued on Alfuzosin SR 5 mg BD and were assessed at 2 and 4 years. Symptomatic assessment was performed with IPSS and QOL symptom score and objective assessment was with urinary flow rate and post void residual volume. Patients who continued to deteriorate symptomatically and objectively or developed further AUR were listed for surgery.


RESULTS
Out of 33 patients, 28 patients were followed up at 2 years (three patients died due to various medical reasons and two did not attend for follow-up). Nineteen patients (68%) underwent transurethral resection of prostate (TURP) for severe lower urinary tract symptom (LUTS) . The mean peak flow rate at 2 years was 8.4 ml/s and the mean residual volume was 112 ml. Ten patients attended for follow up at 4 years. The mean flow rate was 5.17 ml/s and the mean post-void residual volume was 101 ml. Four patients underwent TURP for severe outflow symptoms. At 4 years follow up 24 out of 30 patients (80%) on Alfuzosin needed TURP.


CONCLUSIONS
These data do not support the long term use of alpha-blockers in patients who voided successfully after acute urinary retention.
Palit
V
V
Urology office, Bradford Hospitals NHS Trust, St. Lukes Hospital, Little Horton Lane, Bradford, BD5 0 N A, West Yorkshire, UK. victorpalit@hotmail.com
Shah
T
T
Biyani
C S
CS
Elmasry
Y
Y
Sarkar
R
R
Flannigan
G M
GM
Puri
R
R
D000208:Acute Disease; D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011788:Quality of Life; D011799:Quinazolines / Q000008:administration & dosage / Q000627:therapeutic use*; D020728:Transurethral Resection of Prostate; D017211:Treatment Failure; D016055:Urinary Retention / Q000188:drug therapy* / Q000601:surgery
D000317:Adrenergic alpha-Antagonists; D011799:Quinazolines; C047638:alfuzosin