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Impact of tamsulosin on urinary retention following early catheter removal after robot‐assisted laparoscopic radical prostatectomy: A prospective randomized controlled trial
Author(s) -
Jeong In Gab,
You Dalsan,
Yoon Jong Hyun,
Hong Sungwoo,
Lim Ju Hyun,
Hong Jun Hyuk,
Choo MyungSoo,
Ahn Hanjong,
Kim ChoungSoo
Publication year - 2014
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12225
Subject(s) - medicine , urinary retention , tamsulosin , prostatectomy , urology , clinical endpoint , laparoscopic radical prostatectomy , urinary continence , perioperative , randomized controlled trial , international prostate symptom score , surgery , prostate , lower urinary tract symptoms , cancer , hyperplasia
Objectives To examine the impact of tamsulosin on the rate of acute urinary retention following early catheter removal after robot‐assisted laparoscopic radical prostatectomy. Methods A total of 236 patients who underwent robot‐assisted laparoscopic radical prostatectomy for prostate cancer carried out by a single surgeon were enrolled in this randomized study. Patients were randomly divided into two groups: treatment with tamsulosin (0.4 mg) from 1 day before to 14 days after surgery (tamsulosin group), or no tamsulosin treatment (control group). The urethral catheter was removed on the fifth postoperative day. The primary end‐point was the acute urinary retention rate. Changes in each domain of the I nternational C ontinence S ociety male short‐form questionnaire and uroflowmetry parameters were secondary end‐points. Results The primary end‐point was assessed in 218 patients (92.4%; n = 109 in each group). It was not assessed in 18 patients because of cystographic leak from the vesicourethral anastomosis. The acute urinary retention rate was lower in the tamsulosin group (7.3%) than in the control group (17.4%, P = 0.018). Multivariate logistic regression analysis identified tamsulosin treatment and the operative experience of the surgeon as independent risk factors for acute urinary retention. Tamsulosin‐treated patients had a 0.30‐fold lower risk of developing acute urinary retention compared with control patients (95% confidence interval 0.12–0.76; P = 0.011). None of the I nternational C ontinence S ociety male questionnaire domain scores showed significant changes between the groups. Conclusions Perioperative treatment with tamsulosin in patients undergoing robot‐assisted laparoscopic radical prostatectomy reduces the rate of acute urinary retention after early catheter removal, without aggravating urinary incontinence.