title: Impact of tamsulosin on urinary retention following early catheter removal after robot-assisted laparoscopic radical prostatectomy: a prospective randomized controlled trial.
abstract: OBJECTIVE
  To examine the impact of tamsulosin on the rate of acute urinary retention following early catheter removal after robot-assisted laparoscopic radical prostatectomy.
  
  
  METHODS
  A total of 236 patients who underwent robot-assisted laparoscopic radical prostatectomy for prostate cancer carried out by a single surgeon were enrolled in this randomized study. Patients were randomly divided into two groups: treatment with tamsulosin (0.4 mg) from 1 day before to 14 days after surgery (tamsulosin group), or no tamsulosin treatment (control group). The urethral catheter was removed on the fifth postoperative day. The primary end-point was the acute urinary retention rate. Changes in each domain of the International Continence Society male short-form questionnaire and uroflowmetry parameters were secondary end-points.
  
  
  RESULTS
  The primary end-point was assessed in 218 patients (92.4%; n = 109 in each group). It was not assessed in 18 patients because of cystographic leak from the vesicourethral anastomosis. The acute urinary retention rate was lower in the tamsulosin group (7.3%) than in the control group (17.4%, P = 0.018). Multivariate logistic regression analysis identified tamsulosin treatment and the operative experience of the surgeon as independent risk factors for acute urinary retention. Tamsulosin-treated patients had a 0.30-fold lower risk of developing acute urinary retention compared with control patients (95% confidence interval 0.12-0.76; P = 0.011). None of the International Continence Society male questionnaire domain scores showed significant changes between the groups.
  
  
  CONCLUSIONS
  Perioperative treatment with tamsulosin in patients undergoing robot-assisted laparoscopic radical prostatectomy reduces the rate of acute urinary retention after early catheter removal, without aggravating urinary incontinence.
authors.affiliation: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: In Gab
authors.initials: IG
authors.lastname: Jeong
authors.forename: Dalsan
authors.initials: D
authors.lastname: You
authors.forename: Jong Hyun
authors.initials: JH
authors.lastname: Yoon
authors.forename: Sungwoo
authors.initials: S
authors.lastname: Hong
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Lim
authors.forename: Jun Hyuk
authors.initials: JH
authors.lastname: Hong
authors.forename: Myung-Soo
authors.initials: MS
authors.lastname: Choo
authors.forename: Hanjong
authors.initials: H
authors.lastname: Ahn
authors.forename: Choung-Soo
authors.initials: CS
authors.lastname: Kim
mesh_terms: D000208:Acute Disease; D000368:Aged; D020878:Device Removal / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D018570:Risk Assessment; D012371:Robotics; D013449:Sulfonamides / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D000077409:Tamsulosin; D016896:Treatment Outcome; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000188:drug therapy* / Q000209:etiology; D064804:Urological Agents / Q000008:administration & dosage
chemical_list: D013449:Sulfonamides; D064804:Urological Agents; D000077409:Tamsulosin
keywords: prostatectomy; prostatic neoplasms; tamsulosin; urinary retention