Comparison of tamsulosin hydrochloride versus tamsulosin hydrochloride and deflazacort in relieving postoperative urinary retention in patients undergoing transurethral resection of prostate: a prospective randomized controlled trial in a tertiary care centre

Authors

  • Manu K. Nagabhairava Department of Urology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India
  • Sandeep Puvvada Department of Urology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India
  • Manasa T. Department of Urology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India
  • Mani C. Reddy Department of Urology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India
  • Tarun Javali Department of Urology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India
  • Ramesh D. Department of Urology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20240937

Keywords:

Benign prostatic hyperplasia, Deflazacort, Postoperative urinary retention, Transurethral resection of prostate, Tamsulosin hydrochloride

Abstract

Background: Benign prostatic hyperplasia (BPH) is common amongst the elderly. Even after transurethral resection of prostate (TURP), retention of urine may persist in some leading to significant morbidity adversely affecting the quality of life. The role of alpha blockers in this situation as a combination is unclear. The present study was conducted to evaluate and compare the efficacy of tamsulosin versus tamsulosin and deflazacort in relieving the postoperative retention of urine following TURP.

Methods: After obtaining ethics approval and written informed consent, 72 patients satisfying the eligibility criteria were included. After TURP, patients with urinary retention following catheter removal were randomized into group A (tamsulosin hydrochloride) and group B (tamsulosin hydrochloride and deflazocort). baseline international prostate symptom score (IPSS) score was done to assess quality of life and findings of radiological investigations were noted. Thereafter, medical therapy was done as per assigned group and postoperative findings were documented and analyzed.

Results: Both the groups were similar in terms of demographic characteristics and baseline characteristics. The relief of symptoms was significantly more in group B along with lower IPSS score and residual volume.

Conclusions: We recommend addition of deflazacort to tamsulosin hydrochloride as medical therapy for the management of postoperative retention of urine (POUR), especially following TURP.

References

Bhat SA, Rather SA, Islam N. An overview of benign prostatic hyperplasia and its appreciation in Greco-Arab (Unani) system of medicine. Asian J Urol. 2022;9(2):109-18.

Athanasopoulos A, Chapple C, Fowler C, Gratzke C, Kaplan S, Stief C, et al. The role of antimuscarinics in the management of men with symptoms of overactive bladder associated with concomitant bladder outlet obstruction: an update. Eur Urol. 2011;60(1):94-105.

Roehrborn CG. Benign prostatic hyperplasia: an overview. Rev Urol. 2005;7(9):S3-14.

Irwin DE, Kopp ZS, Agatep B, Milsom I, Abrams P. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int. 2011;108:1132-8.

Ho HS, Yip SK, Lim KB, Fook S, Foo KT, Cheng CW. A prospective randomized study comparing monopolar and bipolar transurethral resection of prostate using transurethral resection in saline (TURIS) system. Eur Urol. 2007;52(2):517-22.

Marszalek M, Ponholzer A, Pusman M, Berger I, Madersbacher S. Transurethral resection of the prostate. Eur Urol. 2009;( 8):504-12.

Marszalek M, Ponholzer A, Pusman M. Transurethral resection of the prostate. Eur Urol. 2009;(l 8):504-12.

Darrah DM, Griebling TL, Silverstein JH. Postoperative urinary retention. Anesthesiol Clin. 2009;27(3):465-84.

Baldini G, Bagry H, Aprikian A, Carli F. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology. 2009;110(5):1139-57.

Elsamra SE, Ellsworth P. Effects of analgesic and anesthetic medications on lower urinary tract function. Urol Nurs 2012;32(2):60-7.

Baldini G, Bagry H, Aprikian A, Carli F. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology. 2009;110:1139-57.

Johnson TV, Abbasi A, Ehrlich SS, Kleris RS, Owen-Smith A, Raison CL, et al. IPSS quality of life question: a possible indicator of depression among patients with lower urinary tract symptoms. Can J Urol. 2012;19(1):6100-4.

Fitzpatrick JM, Desgrandchamps F, Adjali K, Gomez Guerra L, Hong SJ, Reten-World Study Group, et al. Management of acute urinary retention: a worldwide survey of 6074 men with benign prostatic hyperplasia. BJU Int. 2012;109(1):88-95.

Teoh JY, Kan CF, Tsui B, Chiu PK, Man CY, Hou SS, et al. Ambulatory care program for patients presenting with acute urinary retention secondary to benign prostatic hyperplasia. Int Urol Nephrol. 2012;44(6):1593-9.

Manikandan R, Srirangam SJ, O'Reilly PH, Collins GN. Management of acute urinary retention secondary to benign prostatic hyperplasia in the UK: a national survey. BJU Int. 2004;93(1):84-8.

Niël‐Weise BS, van den Broek PJ. Urinary catheter policies for short‐term bladder drainage in adults. Cochrane Database Syst Rev. 2005;3:CD004203.

Schwinn DA, Roehrborn CG. α1-Adrenoceptor subtypes and lower urinary tract symptoms. Int J Urol. 2008;15(3):193-9.

Elbadawi A, Hailemariam S, Yalla SV, Resnick NM. Structural basis of geriatric voiding dysfunction. VI. Validation and update of diagnostic criteria in 71 detrusor biopsies. J Urol. 1997;157(5):1802-13.

Ghuman A, Dawidek MT, Athwal MS, Kasteel N, Brown CJ, Karimuddin AA, et al. Prophylactic tamsulosin and urinary retention rates following elective colorectal surgery: a retrospective cohort study. Int J Colorectal Dis. 2022;37:209-14.

Li H, Zhang W, Xu G, Wang D, Xu C, Zhang H, et al. Prophylactic tamsulosin can reduce the risk of urinary retention after surgery in male patients: A systematic review and meta-analysis. Front Surg. 2022;9:930707.

Rughani A, Cushing D, Lary CW, Cox S, Jumper B, Johnson N, et al. Does tamsulosin decrease postoperative urinary retention in spine surgery? A double-blind, randomized controlled trial. J Neurosurg. 2022;11:1-8.

Basheer A, Alsaidi M, Schultz L, Chedid M, Abdulhak M, Seyfried D. Preventive effect of tamsulosin on postoperative urinary retention in neurosurgical patients. Surg Neurol Int. 2017;8:75.

Nayak S, Acharjya B. Deflazacort versus other glucocorticoids: a comparison. Indian J Dermatol. 2008;53(4):167-70.

Kupeli B, Irkilata L, Gurocak S, Tunc L, Kirac M, Karaoglan U, et al. Does Tamsulosin enhance lower ureteral stone clearance with or without shock wave lithotripsy? Urology. 2004;64(6):1111-5.

Downloads

Published

2024-04-06

How to Cite

Nagabhairava, M. K., Puvvada, S., T., M., Reddy, M. C., Javali, T., & D., R. (2024). Comparison of tamsulosin hydrochloride versus tamsulosin hydrochloride and deflazacort in relieving postoperative urinary retention in patients undergoing transurethral resection of prostate: a prospective randomized controlled trial in a tertiary care centre. International Journal of Research in Medical Sciences, 12(5), 1485–1489. https://doi.org/10.18203/2320-6012.ijrms20240937

Issue

Section

Original Research Articles