Role of alpha blockers and 7-days catheterization in enhancing the success of trial void in acute urinary retention due to benign prostatic hyperplasia: a double-blind randomized control trial

Rohit Garagadahalli Rangaiah, Vilvapathy Senguttuvan Karthikeyan


Background: Acute urinary retention (AUR) in patients with benign prostatic hyperplasia (BPH) is common. This study evaluated the efficacy of three alpha-blockers with urethral catheterization for 7 days in trial without catheter (TWOC).

Methods: This was a prospective, randomized, double-blind, active-control study conducted between November 2013 and May 2016. Patients aged more than 50 years, presenting with first-time painful AUR due to BPH were enrolled in this study. Eligible patients were randomized (1:1:1) to one of the three treatment groups to receive tamsulosin 0.4 mg, alfuzosin 10 mg or silodosin 8 mg for one week. The primary outcome measure was successful TWOC at 7 days.

Results: A total of 118 patients were included in the study (tamsulosin, n=40; alfuzosin, n=38; and silodosin, n=40). The baseline parameters were comparable between the three groups. A total of 84 (71.2%) patients had successful TWOC at the end of 7 days (tamsulosin, n=30 (75%); alfuzosin, n=32 (84%); and silodosin, n=22 (55%)) and was significantly (p=0.015) different between three groups. Higher age, larger volume at retention and higher prostate volume were significantly (p<0.05) associated with the failure of TWOC.

Conclusions: Results from this study demonstrate that there is a definite role of 7-day catheterization with alpha blockers in improving the rates of success of TWOC in men presenting with AUR due to BPH. The success of TWOC is multifactorial.


Acute urinary retention, Alfuzosin, Benign prostatic hyperplasia silodosin, Tamsulosin

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