Alpha blocker treatment appears to increase the chances of successful catheter removal and resumption of normal voiding after an acute urinary retention episode in men.
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).
1. Fisher E, Subramonian K, Omar MI. The role of alpha blockers prior to removal of urethral catheter for acute urinary retention in men. Cochrane Database Syst Rev 2014;(6):CD006744. [PMID:24913721]
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"Alpha Blockers Prior to Removal of a Catheter for Acute Urinary Retention in Adult Men." Evidence-Based Medicine Guidelines, Duodecim Medical Publications Limited, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/EBMG/452338/all/Alpha_blockers_prior_to_removal_of_a_catheter_for_acute_urinary_retention_in_adult_men.
Alpha blockers prior to removal of a catheter for acute urinary retention in adult men. Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. https://evidence.unboundmedicine.com/evidence/view/EBMG/452338/all/Alpha_blockers_prior_to_removal_of_a_catheter_for_acute_urinary_retention_in_adult_men. Accessed September 23, 2020.
Alpha blockers prior to removal of a catheter for acute urinary retention in adult men. (2019). In Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited. Retrieved September 23, 2020, from https://evidence.unboundmedicine.com/evidence/view/EBMG/452338/all/Alpha_blockers_prior_to_removal_of_a_catheter_for_acute_urinary_retention_in_adult_men
Alpha Blockers Prior to Removal of a Catheter for Acute Urinary Retention in Adult Men [Internet]. In: Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. [cited 2020 September 23]. Available from: https://evidence.unboundmedicine.com/evidence/view/EBMG/452338/all/Alpha_blockers_prior_to_removal_of_a_catheter_for_acute_urinary_retention_in_adult_men.
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