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Alpha-blockers increase the chances of a successful trial without catheter after acute urinary retention

Report by: Simon Rendell, Senior Emergency Trainee

Search checked by: Laith Sultan, Senior Emergency Trainee and Bernard A Foëx, Consultant in Emergency Medicine and Critical Care

Institution: Manchester Royal Infirmary, Manchester, UK

A short-cut review was carried out to establish whether treatment with an alpha-blocker would increase the chances of a successful trial without catheter (TWOC) after an episode of acute urinary retention (AUR). Six studies and one systematic review were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that alpha-blockers do increase the success rates of early TWOC after AUR.

Three-part question

In [adult men presenting with urinary retention secondary to benign prostatic hyperplasia] are [alpha-blockers compared with placebo] more likely to lead to a [successful early trial without catheter]?

Clinical scenario

A previously well 60-year-old man attends your emergency department in AUR for the past 10 h. On closer questioning he reveals a history of preceding lower urinary tract symptoms.

Following the uneventful passage of a urethral catheter, the production of a residual volume less than …

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