Do alpha-blockers prevent the occurrence of acute urinary retention?

Acute urinary retention (AUR) is a common complication of benign prostatic hyperplasia (BPH) and the incidence varies widely from 0.4 to 25% per year in men seen in urology practices. It has been estimated that AU R is the in dication for surgery in around 25-30% of patients undergoing transurethral resection of the prostate (TURP) and that emergency TURF for AUR is associa ted with greater morbidity than elective TURF. Risk factors for AUR include lower urinary tract symptoms (LUTS), depressed peak urinary flow rate, enl arged prostate, high postvoid residual (PVR) urine and old age. Alfuzosin h as been shown to significantly increase maximum flow rate and relieve bladd er outlet obstruction, resulting in a reduction in PVR urine. A pooled anal ysis of 11 placebo controlled studies involving 1,470 patients with LUTS su ggestive of BPH indicates that significantly greater improvements were obse rved in patients treated with alfuzosin than with placebo. A 8-month placeb o controlled study of 518 patients reported a 0.4% incidence of AUR in the alfuzosin group compared with a 2.4% incidence with placebo (p = 0.04), The se positive effects on PVR could be related to the reduction in incidence o f AUR seen in alfuzosin-treated patients. Copyright (C) 2001 S. Karger AG. Basel.