Alpha blockers in the management of acute urinary retention in prostatomegaly: a prospective observational study

Document Type : Original Article

Authors

1 Department of Pharmacy, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India

2 Department of Urology, SBKS Medical Institute, and Research Centre, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India

Abstract

Background
Acute urinary retention (AUR) from prostatomegaly presents clinical challenges.
Alpha blockers like tamsulosin and silodosin effectively alleviate AUR symptoms by
relaxing bladder and prostate smooth muscles, and enhancing urine flow.
Objective
The study aims to assess the incidence of AUR in prostatomegaly patients,
compare the efficacy of various alpha blockers in AUR management, and
investigate associated side effects and adverse drug reactions.
Patients and methods
A total of 60 patients with confirmed prostatomegaly-induced AUR, determined by
ultrasonography, were enrolled. The study evaluated the efficacy of alpha-blockers
through pre- and postultrasonography assessments of prostate size and regular
follow-ups at different intervals (5, 7, 8, and 15 days). Statistical analysis, including
paired t-tests, was conducted to compare the efficacy of tamsulosin and silodosin.
Result and conclusion
Tamsulosin and silodosin were compared, revealing a significant reduction in
prostate size for both drugs. However, tamsulosin demonstrated a greater
paired difference (11.16) compared with silodosin (9.96). Cohen’s D values
further supported the superior efficacy of tamsulosin (2.52) over silodosin (1.49).
Tamsulosin also exhibited fewer side effects (five patients) compared with silodosin
(eight patients), establishing it as the more effective alpha-blocker with minimal side
effects in AUR with prostatomegaly patients. Patients aged 61–70 and smokers
showed increased AUR risk. Tamsulosin outperformed silodosin in reducing
prostate size, relieving AUR symptoms, and minimizing side effects,
demonstrating effectiveness in AUR management.

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