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KMID : 1011820210620050569
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Investigative and Clinical Urology
2021 Volume.62 No. 5 p.569 ~ p.576
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Preventive effects of tamsulosin for postoperative urinary retention after lower limb arthroplasty: A randomized controlled study
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Choi Chang-Il
Kim Jong-Keun
Choo Min-Soo
Lee Seong-Ho
Chang Jun-Dong
Han Jun-Hyun
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Abstract
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Purpose: This prospective, randomized, controlled study investigated the use of tamsulosin, a selective alpha-blocker, as a prophylactic medication to prevent postoperative urinary retention (POUR) following lower limb arthroplasty.
Materials and Methods: The criterion for diagnosing POUR was used a postoperative bladder volume over 400 mL with incomplete emptying. Patients who underwent primary total hip or knee arthroplasty were randomly assigned at a 1:1 ratio to tamsulosin treatment and non-treatment groups at a single center from September 2018 to November 2018. The treatment group received 0.2 mg of tamsulosin orally once at night for 3 days starting on postoperative day 1. During this 3-day period, an indwelling Foley catheter was maintained. The incidence of POUR according to tamsulosin treatment following lower limb arthroplasty was the primary outcome.
Results: In total, 100 patients were enrolled, of whom 5 discontinued participation. POUR was diagnosed in 20 of the remaining 95 patients (21.1%). The treatment group contained 48 patients, of whom 6 (12.5%) developed POUR, whereas POUR occurred in the 14 of the 47 patients (29.8%) in the non-treatment group. Tamsulosin treatment reduced the risk of POUR by two-thirds (odds ratio [OR], 0.337; 95% confidence interval [CI], 0.117?0.971; p=0.044). The risk reduction associated with tamsulosin treatment remained robust post-adjustment for potential covariates (OR, 0.250; 95% CI, 0.069?0.905; p=0.038).
Conclusions: Tamsulosin administration immediately after lower limb arthroplasty reduced the incidence of urinary retention and diminished the need for long-term catheterization.
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KEYWORD
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Adrenergic alpha-antagonists, Aged, Arthroplasty, Urinary retention
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