A Cochrane review 1 included 9 studies. Eight trials compared alpha blockers versus placebo (five trials tested alfuzosin and two trials tested tamsulosin, one trial tested both alfuzosin and tamsulosin, one trial tested silodosin) and one trial compared an alpha blocker (doxazosin) versus no treatment. Trial without catheter was performed after treatment with the drug for one to three days in seven trials and for eight and 32 days in two other trials respectively. Overall rates of successful TWOC favoured alpha blockers over placebo (RR 1.55, 95% CI 1.36 to 1.76). The incidence of recurrent acute urinary retention was lower in groups treated with an alpha blocker (RR 0.69, 95% CI 0.60 to 0.79). Overall side effects were low for both placebo and alpha blockers.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment).
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