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- Essai clinique NCT07654413
Tamsulosin With or Without Tadalafil for Trial Without Catheter After Acute Urinary Retention Due to Benign Prostatic Hyperplasia (TAMS-TAD-TWOC)
Tamsulosin With Versus Without Tadalafil for Trial Without Catheter After Acute Urinary Retention Due to Benign Prostatic Hyperplasia: A Prospective Double-Blind Randomized Trial
Acute urinary retention is a common emergency in men with benign prostatic hyperplasia. After bladder drainage with a urethral catheter, patients usually undergo a trial without catheter to determine whether they can pass urine again without recatheterization.
This study will evaluate whether adding tadalafil 5 mg once daily to tamsulosin 0.4 mg once daily improves the chance of successful trial without catheter in men with first-episode acute urinary retention due to presumed benign prostatic hyperplasia.
Participants will be randomly assigned to receive either tamsulosin plus tadalafil or tamsulosin plus a matching placebo. Study medication will start within 24 hours after catheterization. The catheter will be removed on Day 7. If the first trial without catheter fails, the catheter will be reinserted and a second rescue trial without catheter will be performed on Day 14.
The main outcome is overall catheter-free success by Day 14. Participants will also be followed for recurrent urinary retention, post-void residual urine, urinary flow, catheter-related complications, drug-related adverse events, and the need for benign prostatic hyperplasia-related surgery within 3 months.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Type d'étude
Inscription (Estimé)
Phase
- Phase 4
Contacts et emplacements
Coordonnées de l'étude
- Nom: Hany F Badawy, MD
- Numéro de téléphone: +201149525028
- E-mail: HANYFATHY86@GMAIL.COM
Lieux d'étude
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Beni Suweif Governorate
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Banī Suwayf, Beni Suweif Governorate, Egypte, 02456
- Recrutement
- Department of Urology- Beni-Suef University Hospitals
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Contact:
- Hany F Badawy, MD
- Numéro de téléphone: +201149525028
- E-mail: HANYFATHY86@GMAIL.COM
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Chercheur principal:
- Hany F Badawy, MD
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Contact:
- E-mail: HANYFATHY86@GMAIL.COM
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
Inclusion Criteria:
- Male patient aged 50 years or older.
- First episode of spontaneous painful acute urinary retention.
- Successful urethral catheterization at presentation.
- Drained urine volume at presentation of at least 300 mL.
- Clinical impression of benign prostatic obstruction or benign prostatic hyperplasia based on history, digital rectal examination, and/or ultrasound evidence of enlarged prostate.
- Ability to provide written informed consent.
Exclusion Criteria:
- Previous episode of acute urinary retention.
- Chronic painless urinary retention phenotype.
- Active urinary tract infection or sepsis.
- Gross hematuria with clot retention.
- Suspected or known urethral stricture.
- Neurogenic bladder or major neurologic disease affecting voiding.
- History of prostate cancer or bladder cancer.
- Previous prostate surgery.
- Current use of nitrates or guanylate cyclase stimulators.
- Contraindication to tadalafil or tamsulosin.
- Severe hypotension or unstable cardiovascular disease.
- Severe renal impairment.
- Severe hepatic impairment.
- Current or recent use of phosphodiesterase type 5 inhibitors before enrollment.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Quadruple
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Comparateur placebo: Tamsulosin Plus Placebo
Participants will receive tamsulosin 0.4 mg once daily plus a matching placebo once daily.
Treatment will start within 24 hours after urethral catheterization and continue until the Day-7 trial without catheter.
Participants who fail the Day-7 trial without catheter will continue the assigned treatment until the rescue trial without catheter on Day 14.
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Tamsulosin 0.4 mg will be administered orally once daily as open-label background therapy in both study arms.
Treatment will start within 24 hours after urethral catheterization and continue until the scheduled Day-7 trial without catheter.
Participants who fail the Day-7 trial without catheter will continue treatment until the rescue trial without catheter on Day 14.
A matching placebo tablet will be administered orally once daily in the placebo comparator arm in addition to open-label tamsulosin 0.4 mg once daily.
The placebo will be identical to tadalafil in appearance, packaging, and labeling to maintain blinding.
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Expérimental: Tamsulosin Plus Tadalafil
Participants will receive tamsulosin 0.4 mg once daily plus tadalafil 5 mg once daily.
Treatment will start within 24 hours after urethral catheterization and continue until the Day-7 trial without catheter.
Participants who fail the Day-7 trial without catheter will continue the assigned treatment until the rescue trial without catheter on Day 14.
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Tamsulosin 0.4 mg will be administered orally once daily as open-label background therapy in both study arms.
Treatment will start within 24 hours after urethral catheterization and continue until the scheduled Day-7 trial without catheter.
Participants who fail the Day-7 trial without catheter will continue treatment until the rescue trial without catheter on Day 14.
Tadalafil 5 mg will be administered orally once daily in the experimental arm in addition to open-label tamsulosin 0.4 mg once daily.
Treatment will start within 24 hours after urethral catheterization and continue until the scheduled Day-7 trial without catheter.
Participants who fail the Day-7 trial without catheter will continue treatment until the rescue trial without catheter on Day 14.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Overall Catheter-Free Success by Day 14
Délai: Day 14
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Proportion of participants who achieve successful spontaneous voiding after either the scheduled Day-7 trial without catheter or the rescue Day-14 trial without catheter.
Success is defined as spontaneous voiding after catheter removal, voided volume of at least 100 mL, post-void residual urine less than 150 mL measured within 10-15 minutes after voiding, no recatheterization within 24 hours after the relevant trial without catheter attempt, and remaining catheter-free until Day 14 for participants who initially pass the Day-7 trial without catheter.
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Day 14
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Successful Day-7 Trial Without Catheter
Délai: Day 7
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Proportion of participants who achieve successful spontaneous voiding after catheter removal on Day 7. Success is defined as spontaneous voiding, voided volume of at least 100 mL, post-void residual urine less than 150 mL measured within 10-15 minutes after voiding, and no recatheterization within 24 hours.
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Day 7
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Successful Rescue Day-14 Trial Without Catheter Among Day-7 Failures
Délai: Day 14
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Proportion of participants who fail the Day-7 trial without catheter and subsequently achieve successful rescue trial without catheter on Day 14 using the same predefined success criteria: spontaneous voiding, voided volume of at least 100 mL, post-void residual urine less than 150 mL measured within 10-15 minutes after voiding, and no recatheterization within 24 hours.
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Day 14
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Recurrent Acute Urinary Retention Within 30 Days
Délai: 30 days
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Proportion of participants who develop recurrent painful acute urinary retention requiring recatheterization within 30 days after randomization.
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30 days
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Need for Benign Prostatic Hyperplasia-Related Surgery Within 3 Months
Délai: 3 months
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Proportion of participants who require surgical intervention for benign prostatic hyperplasia or benign prostatic obstruction within 3 months after randomization.
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3 months
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Collaborateurs et enquêteurs
Parrainer
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- Maladies urogénitales
- Maladies génitales
- Maladies génitales, sexe masculin
- Maladies de la prostate
- Maladies urogénitales masculines
- Hyperplasie prostatique
- Composés de soufre
- Produits chimiques organiques
- Pyridines
- Composés hétérocycliques, 1 anneau
- Composés hétérocycliques
- Composés hétérocycliques, 2 anneaux
- Composés hétérocycliques, anneau fusionné
- Hydrocarbures
- Hydrocarbures, cyclique
- Hydrocarbures, aromatique
- Amides
- Indoles
- Dérivés de benzène
- Alcaloïdes indole
- Benzènesulfonamides
- Sulfonamides
- Sulfones
- Composés hétérocycliques, 3 ring
- Carbolines
- Tadalafil
- Tamsulosine
Autres numéros d'identification d'étude
- BSU FMBSUREC07062026CBADAWY
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Description du régime IPD
Informations sur les médicaments et les dispositifs, documents d'étude
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