title: Does sildenafil enhance the effect of tamsulosin in relieving acute urinary retention?
abstract: OBJECTIVE
  To compare the safety and efficacy of combined therapy using sildenafil and tamsulosin for management of acute urinary retention (AUR) with tamsulosin alone in patients with benign prostate hyperplasia (BPH).
  
  
  METHODS
  101 patients were enrolled in a randomized placebo-controlled study from June 2009 to April 2012. Patients presenting with an initial episode of spontaneous AUR underwent urethral catheterization and then prospectively randomized to receive tamsulosin 0.4 mg plus sildenafil 50mg in group A and tamsulosin 0.4 mg plus placebo in group B for three days. Urethral catheter was removed three days after medical treatment and patient's ability to void assessed at the day after catheter removal and seven days later. Patients who voided successfully were followed at least for three months.
  
  
  RESULTS
  Mean age of patients was 59.64 ± 3.84 years in group A and 60.56 ± 4.12 years in group B (p value = 0.92). Mean prostate volume and mean residual urine were comparable between both groups (p value = 0.74 and 0.42, respectively). Fifteen patients in group A (success rate: 70%) and nineteen patients in group B (success rate: 62.7%) had failed trial without catheter (TWOC) at 7th day following AUR (p value = 0.3). No significant difference was noted between both groups regarding the rate of repeated AUR at one month and three month follow-up period (p = 0.07 and p = 0.45, respectively).
  
  
  CONCLUSIONS
  It seems that combination therapy by using 5-phosphodiesterase inhibitor and tamsulosin has no significant advantages to improve urinary retention versus tamsulosin alone.
authors.affiliation: Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, I.R. Iran.
authors.forename: Seyed Hossein Hosseini
authors.initials: SH
authors.lastname: Sharifi
authors.affiliation: Zabol research center, Zabol University of medical science, Zabol, I.R. Iran.
authors.forename: Mohsen Heidari
authors.initials: MH
authors.lastname: Mokarrar
authors.affiliation: Nephrology department of Firoozgar hospital, Tehran University of Medical Sciences (TUMS), Tehran, I.R. Iran.
authors.forename: Flora
authors.initials: F
authors.lastname: Khaledi
authors.affiliation: Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, I.R. Iran.
authors.forename: Reyhaneh
authors.initials: R
authors.lastname: Yamini-Sharif
authors.affiliation: Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, I.R. Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Lashay
authors.affiliation: Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, I.R. Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Soltani
mesh_terms: D000208:Acute Disease; D058668:Adrenergic alpha-1 Receptor Antagonists / Q000008:administration & dosage*; D000704:Analysis of Variance; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D058986:Phosphodiesterase 5 Inhibitors / Q000008:administration & dosage*; D010879:Piperazines / Q000008:administration & dosage*; D011470:Prostatic Hyperplasia / Q000188:drug therapy* / Q000503:physiopathology; D011687:Purines / Q000008:administration & dosage; D000068677:Sildenafil Citrate; D013449:Sulfonamides / Q000008:administration & dosage*; D013450:Sulfones / Q000008:administration & dosage*; D000077409:Tamsulosin; D013997:Time Factors; D016896:Treatment Outcome; D014546:Urinary Catheterization; D062885:Urinary Catheters; D016055:Urinary Retention / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D058986:Phosphodiesterase 5 Inhibitors; D010879:Piperazines; D011687:Purines; D013449:Sulfonamides; D013450:Sulfones; D000068677:Sildenafil Citrate; D000077409:Tamsulosin