Preventive effect of tamsulosin on postoperative urinary retention

Mohammadreza Mohammadi-Fallah, Sepehr Hamedanchi, Ali Tayyebi-Azar, Mohammadreza Mohammadi-Fallah, Sepehr Hamedanchi, Ali Tayyebi-Azar

Abstract

Purpose: To investigate the prophylactic effect of Tamsulosin, a super-selective alpha-1a adrenergic blocking agent, on the development of urinary retention in men undergoing elective inguinal herniorrhaphy.

Materials and methods: From May 2010 through November 2011, a total of 80 males who underwent elective inguinal herniorrhaphy in a university hospital were included in this study. Patients were randomly assigned to one of two groups. In group one (control), the patients were given two doses of placebo orally, 6 hours before surgery and 6 to 12 hours after surgery. Patients in group two were given 0.4 mg of Tamsulosin orally in the same manner as the placebo. All patients were closely followed for 24 hours post-operatively, and any voiding difficulties or urinary retention was recorded.

Results: There were 40 patients in group one (control group) and 40 patients in group two (Tamsulosin group). The patients' mean age was 64 years. In group one, 6 patients and in group two, 1 patient required catheterization. Thus, 15% of patients in group I and 2.5% of patients in group II had urinary retention. The difference in the requirement for catheterization was statistically significant (p=0.04). The technique of herniorrhaphy, the side of the body in which the hernia was located, the type of anesthesia, the duration of the surgery, and the severity of pre-operative urinary symptoms had no significant effect on the incidence of urinary retention.

Conclusions: The use of perioperative Tamsulosin represents an effective strategy to reduce the risk of post-operative urinary retention following inguinal herniorrhaphy.

Keywords: Adrenergic alpha-Antagonists; Herniorrhaphy; Tamsulosin; Urinary retention.

Conflict of interest statement

The authors have nothing to disclose.

References

    1. Stallard S, Prescott S. Postoperative urinary retention in general surgical patients. Br J Surg. 1988;75:1141–1143.
    1. Goldman G, Leviav A, Mazor A, Kashtan H, Aladgem D, Greenstein A, et al. Alpha-adrenergic blocker for posthernioplasty urinary retention. Prevention and treatment. Arch Surg. 1988;123:35–36.
    1. Gonullu NN, Dulger M, Utkan NZ, Canturk NZ, Alponat A. Prevention of postherniorrhaphy urinary retention with prazosin. Am Surg. 1999;65:55–58.
    1. Baldini G, Bagry H, Aprikian A, Carli F. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology. 2009;110:1139–1157.
    1. Petros JG, Rimm EB, Robillard RJ, Argy O. Factors influencing postoperative urinary retention in patients undergoing elective inguinal herniorrhaphy. Am J Surg. 1991;161:431–433.
    1. Toyonaga T, Matsushima M, Sogawa N, Jiang SF, Matsumura N, Shimojima Y, et al. Postoperative urinary retention after surgery for benign anorectal disease: potential risk factors and strategy for prevention. Int J Colorectal Dis. 2006;21:676–682.
    1. Lee SJ, Kim YT, Lee TY, Woo YN. Analysis of risk factors for acute urinary retention after non-urogenital surgery. Korean J Urol. 2007;48:1277–1284.
    1. Lee KS, Lim KH, Kim SJ, Choi HJ, Noh DH, Lee HW, et al. Predictors of successful trial without catheter for postoperative urinary retention following non-urological surgery. Int Neurourol J. 2011;15:158–165.
    1. Zaheer S, Reilly WT, Pemberton JH, Ilstrup D. Urinary retention after operations for benign anorectal diseases. Dis Colon Rectum. 1998;41:696–704.
    1. Lepor H. Managing and preventing acute urinary retention. Rev Urol. 2005;7(Suppl 8):S26–S33.
    1. Bailey HR, Ferguson JA. Prevention of urinary retention by fluid restriction following anorectal operations. Dis Colon Rectum. 1976;19:250–252.
    1. Bross S, Schumacher S, Scheepe JR, Zendler S, Braun PM, Alken P, et al. Effects of acute urinary bladder overdistension on bladder response during sacral neurostimulation. Eur Urol. 1999;36:354–359.
    1. Finley RK, Jr, Miller SF, Jones LM. Elimination of urinary retention following inguinal herniorrhaphy. Am Surg. 1991;57:486–488.
    1. Jensen P, Mikkelsen T, Kehlet H. Postherniorrhaphy urinary retention--effect of local, regional, and general anesthesia: a review. Reg Anesth Pain Med. 2002;27:612–617.
    1. Mulroy MF. Hernia surgery, anesthetic technique, and urinary retention-apples, oranges, and kumquats? Reg Anesth Pain Med. 2002;27:587–589.
    1. Wein AJ, Dmochowski RR. Neuromuscular dysfunction of the lower urinary tract. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh urology. 10th ed. Philadelphia: Saunders; 2012. p. 1940.
    1. Buckley BS, Lapitan MC. Drugs for treatment of urinary retention after surgery in adults. Cochrane Database Syst Rev. 2010;(10):CD008023.
    1. Finkbeiner AE. Is bethanechol chloride clinically effective in promoting bladder emptying? A literature review. J Urol. 1985;134:443–449.
    1. Patel R, Fiske J, Lepor H. Tamsulosin reduces the incidence of acute urinary retention following early removal of the urinary catheter after radical retropubic prostatectomy. Urology. 2003;62:287–291.
    1. Djavan B, Shariat S, Fakhari M, Ghawidel K, Seitz C, Partin AW, et al. Neoadjuvant and adjuvant alpha-blockade improves early results of high-energy transurethral microwave thermotherapy for lower urinary tract symptoms of benign prostatic hyperplasia: a randomized, prospective clinical trial. Urology. 1999;53:251–259.

Source: PubMed

3
Prenumerera