Randomized controlled trial of tamsulosin for prevention of acute voiding difficulty after rectal cancer surgery.
BACKGROUND
We conducted a randomized clinical trial to investigate the efficacy of the selective α(1A)-adrenoceptor antagonist tamsulosin in preventing acute voiding difficulty after rectal cancer surgery.


METHODS
A total of 94 rectal cancer patients with an International Prostate Symptom Score (IPSS) of ≤7 were randomly assigned (1:1) to the tamsulosin group (0.2 mg/day orally for 7 days) (n = 47) or the control group (n = 47). The primary endpoint was the reinsertion rate of the urinary catheter after its removal on postoperative day (POD) 3. The secondary endpoints included the maximum (Qmax) and average (Qavg) urinary flow rates on POD 3, and the voided volume (VV), residual urine volume (RU), and IPSS on POD 7. Analyses were based on an intention-to-treat population.


RESULTS
The reinsertion rate of the urinary catheter in the tamsulosin group was similar to that in the control group (23.4 vs. 21.3 %, respectively; p = 0.804). The postoperative voiding parameters and IPSS were not better in the tamsulosin group than in the control group after adjustments were made for the baseline measurements with analysis of covariance (Qmax, p = 0.537; Qavg, p = 0.399; VV, p = 0.645; RU, p = 0.703; IPSS, p = 0.761). Multivariate analysis revealed that being male was the only independent risk factor for reinsertion of the urinary catheter (odds ratio 0.239; 95 % confidence interval 0.069-0.823; p = 0.023).


CONCLUSIONS
This controlled trial showed that tamsulosin at 0.2 mg/day does not prevent acute voiding difficulty after rectal cancer surgery.
Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea.
Je-Ho
JH
Jang
Sung-Bum
SB
Kang
Sung-Min
SM
Lee
Jun-Seok
JS
Park
Duck-Woo
DW
Kim
Soyeon
S
Ahn
D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012004:Rectal Neoplasms / Q000601:surgery*; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D014555:Urination Disorders / Q000517:prevention & control*
D058668:Adrenergic alpha-1 Receptor Antagonists; D013449:Sulfonamides; D000077409:Tamsulosin