Abstracto

Alfuzosin 10 mg once daily in the management of acute urinary retention of benign prostatic hyperplasia

Manaf M Rahma Al-Hashimi

Background: Acute urinary retention is regarded as the most serious hazard of untreated benign prostatic hyperplasia. α-blockers is frequently used for acute urinary retention as it is proved to be of value for successful trial without catheter after acute urinary retention and to decrease the need for benign prostatic hyperplasia related surgery.

Objectives: To evaluate the significance of alfuzosin 10 mg once daily for successful trial without catheter in patients with acute urinary retention and long-term management.

Methods: Total of 245 enrolled acute urinary retention patients were catheterized and randomized to either alfuzosin 10 mg once daily or placebo for 3 days (first phase), all the failed patients extend their treatment for another 3 days for a second trial without catheter (second phase). The successful patients from both phases were re-randomized for alfuzosin 10 mg once daily or placebo for 12 months, the outcomes were the recurrence of acute urinary retention or the need for surgery (third phase).

Results: In the first phase alfuzosin have significant value for successful trial without catheter compared with placebo (62.3 vs 32.7%; p = 0.0001), in the second phase still of significance in comparison to placebo (32.6 versus 9.5%; p = 0.002) while In the third phase, alfuzosin compared with placebo was of statistical significance regarding reducing the recurrence of acute urinary retention only in the first month (1.8 vs 11.3%; p = 0.04) and the third month (3.7 vs 16.9%; p = 0.02), also regarding the need for surgery (3.7 vs 15.0%; p = 0.04) and (7.4 vs 20.7%; p = 0.04), respectively. This corresponds to risk reduction of surgery in alfuzosin group of 76% in the first month and 65% in the third month.

Conclusion: Alfuzosin 10 mg once daily is of value for successful trial without catheter after acute urinary retention and a second trial of voiding in failed first trial is recommended. It reduced the recurrence of acute urinary retention and the need of related surgery especially during first three months of treatment.