Prophylactic effects of alpha-blockers, Tamsulosin and Alfuzosin, on postoperative urinary retention in male patients undergoing urologic surgery under spinal anaesthesia

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Vol. 42 (3): 578-584, May – June, 2016

doi: 10.1590/S1677-5538.IBJU.2015.0256


ORIGINAL ARTICLE

Prophylactic effects of alpha-blockers, Tamsulosin and Alfuzosin, on postoperative urinary retention in male patients undergoing urologic surgery under spinal anaesthesia

Ali Akkoc 1, Cemil Aydin 1, Ramazan Topaktas 1, Mahir Kartalmis 2, Selcuk Altin 1, Kenan Isen 1, Ahmet Metin 3
1 Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey; 2 Department of Urology, Selahaddin Eyyubi State Hospital, Diyarbakir, Turkey; 3 Department of Urology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey

ABSTRACT          

Purpose: Postoperative urinary retention (POUR) is one of the most common compli¬cations after surgical procedures under spinal anaesthesia. Recent studies have shown the beneficial effects of alpha-adrenergic blockers in preventing POUR. The aim of this prospective study was to investigate and compare the prophylactic effects of tamsulo¬sin and alfuzosin on POUR after urologic surgical procedures under spinal anaesthesia.
Materials and Methods: A total of 180 males who underwent elective urologic surgery were included in this study. The patients were randomly allocated into three Groups. The Group I received placebo. Patients in Group II were given 0.4mg of tamsulosin orally 14 and 2 hours before surgery. Patients in Group III were given 10mg of alfuzo¬sin ER orally 10 and 2 hours before surgery. All patients were closely followed for 24 hours postoperatively and their episodes of urinary retentions were recorded.
Results: There were 60 patients in each Group. Their mean age was 35.95±15.16 years. Fifteen patients in Group I (25%), 3 patients in Group II (5%) and 4 patients in Group III (6.7%) required catheterization because of urinary retention. In tamsulosin group and alfuzosin group, there were a significantly lower proportion of patients with POUR compared with the placebo Group (p=0.002 and p=0.006). The beneficial effects of ta¬msulosin and alfuzosin on POUR were similar between both Groups (p=0.697).
Conclusion: This study suggests that the use of prophylactic tamsulosin or alfuzosin can reduce the incidence of urinary retention and the need for catheterization after urologic surgical procedures under spinal anaesthesia.

Keywords: Adrenergic alpha-Antagonists; Postoperative Period; Urinary Retention; Anesthesia, Spinal

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