Prophylactic effects of alpha-blockers, Tamsulosin and Alfuzosin, on postoperative urinary retention in male patients undergoing urologic surgery under spinal anaesthesia.
OBJECTIVE
Postoperative urinary retention (POUR) is one of the most common complications after surgical procedures under spinal anaesthesia. Recent studies have shown the beneficial effects of alpha-adrenergic blockers in preventing POUR. The aim of this prospective study was to investigate and compare the prophylactic effects of tamsulosin and alfuzosin on POUR after urologic surgical procedures under spinal anaesthesia.


METHODS
A total of 180 males who underwent elective urologic surgery were included in this study. The patients were randomly allocated into three Groups. The Group I received placebo. Patients in Group II were given 0.4mg of tamsulosin orally 14 and 2 hours before surgery. Patients in Group III were given 10mg of alfuzosin ER orally 10 and 2 hours before surgery. All patients were closely followed for 24 hours postoperatively and their episodes of urinary retentions were recorded.


RESULTS
There were 60 patients in each Group. Their mean age was 35.95±15.16 years. Fifteen patients in Group I (25%), 3 patients in Group II (5%) and 4 patients in Group III (6.7%) required catheterization because of urinary retention. In tamsulosin group and alfuzosin group, there were a significantly lower proportion of patients with POUR compared with the placebo Group (p=0.002 and p=0.006). The beneficial effects of tamsulosin and alfuzosin on POUR were similar between both Groups (p=0.697).


CONCLUSIONS
This study suggests that the use of prophylactic tamsulosin or alfuzosin can reduce the incidence of urinary retention and the need for catheterization after urologic surgical procedures under spinal anaesthesia.
Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
Ali
A
Akkoc
Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
Cemil
C
Aydin
Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
Ramazan
R
Topaktas
Department of Urology, Selahaddin Eyyubi State Hospital, Diyarbakir, Turkey.
Mahir
M
Kartalmis
Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
Selcuk
S
Altin
Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
Kenan
K
Isen
Department of Urology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
Ahmet
A
Metin
D000293:Adolescent; D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D065129:Pre-Exposure Prophylaxis / Q000379:methods*; D011446:Prospective Studies; D011799:Quinazolines / Q000627:therapeutic use*; D015203:Reproducibility of Results; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D013997:Time Factors; D016896:Treatment Outcome; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000209:etiology / Q000517:prevention & control*; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects*; D055815:Young Adult
D058668:Adrenergic alpha-1 Receptor Antagonists; D011799:Quinazolines; D013449:Sulfonamides; C047638:alfuzosin; D000077409:Tamsulosin