📃 Paper Title: Alfuzosin once daily facilitates return to voiding in patients in acute urinary retention
🧍 Author: McNeil
🕒 Year: 2004
📚 Journal: The Journal of Urology
🌎 Country: UK
ㅤContext to the study:
Can you tell me about a study that showed a benefit for alfuzosin after acute urinary retention
ㅤ✅ Take-home message of study:
Alfuzosin increased successful TWOC
48% placebo v 62% Alfuzosin (p=0.012)
Alfuzosin was well tolerated even in elderly men (2.5% postural hypotension incidence)
(Second phase McNeil 2005: Alfuzosin 10mg OD also reduced need for BPH surgery during a 6-month treatment period)
ㅤ Double-blind placebo-controlled RCT
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Study participants:
363 patients who need emergency catheterization for AUR at 71 centres in Europe and South Africa
With drained vol 0.5-1.5L, and being the patient's first AUR presentation
All causes of precipitated AUR were exclusion criteria except constipation and a high fluid intake
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Key study outcomes:
Alfuzosin (10 mg) once daily significantly improved the rate of successful TWOC (62%) in patients with AUR related to BPH compared to placebo (48%, p=0.012)
even for elderly patients and those with a large drained volume (I.e. at increased risk for TWOC failure)
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Study Limitations:
Patient population were those presenting as an emergency - whereas most clinical studies for BPH are done in OPD setting.
-thus, rather long recruitment period of >2 years
The catheter was removed after 2 or 3 days of catheterization (2 doses of drug). - we know the success rate of TWOC increases with duration of catheterization, therefore this might explain the higher placebo success rate compared to other studies with less time before TWOC
No value of PVR was specified for post TWOC
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