Impact of tamsulosin on urinary retention following early catheter removal after robot-assisted laparoscopic radical prostatectomy: a prospective randomized controlled trial.
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 International Continence Society 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 International Continence Society 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.
['Jeong|In Gab|IG|', 'You|Dalsan|D|', 'Yoon|Jong Hyun|JH|', 'Hong|Sungwoo|S|', 'Lim|Ju Hyun|JH|', 'Hong|Jun Hyuk|JH|', 'Choo|Myung-Soo|MS|', 'Ahn|Hanjong|H|', 'Kim|Choung-Soo|CS|']
D000208:Acute Disease D000368:Aged D020878:Device Removal D006801:Humans D010535:Laparoscopy D016015:Logistic Models D008297:Male D008875:Middle Aged D011446:Prospective Studies D011468:Prostatectomy D011471:Prostatic Neoplasms D018570:Risk Assessment D012371:Robotics D013449:Sulfonamides D011795:Surveys and Questionnaires D000077409:Tamsulosin D016896:Treatment Outcome D014546:Urinary Catheterization D016055:Urinary Retention D064804:Urological Agents
tamsulosin urinary retention prostatectomy prostatic neoplasms