α1-Blockers in the management of acute urinary retention secondary to benign prostatic hyperplasia: a systematic review and meta-analysis
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α1-Blockers have been widely used in the conservative management of acute urinary retention (AUR).
To compare the efficacy and safety of α1-blockers in male patients with AUR secondary to benign prostatic hyperplasia (BPH).
Electronic searches on PubMed/MEDLINE, EMBASE and the Cochrane Library were performed to identify all published randomized controlled trials (RCTs) and controlled clinical trials (CCTs) of α1-blockers for the treatment of AUR. Relevant reviews and reference lists of included studies were explored.
Nine studies involving a total of 1051 men were enrolled in this review. Compared to 38.9 % (161/414) in control groups, 56.8 % (362/637) of patients receiving α1-blockers had a successful trial without catheter (TWOC). Meta-analysis demonstrated that α1-blockers have a substantial effect on the successful resumption of micturition after TWOC (RR = 1.45, 95 % CI 1.20–1.75, P = 0.0001). In the subsequent phase, the outcomes across studies indicated that α1-blockers may provide little benefit to maintain the satisfactory voiding without AUR recurrence or BPH surgery in a long-term follow-up. α1-Blockers were generally low and well tolerated in both phases.
In conclusion, α1-blockers provide substantial benefit in increasing a satisfactory micturition within 24 h after TWOC for men with AUR due to BPH, even though the long-term effectiveness remains uncertain.
KeywordsAcute urinary retention Benign prostatic hyperplasia Alpha-blockers Trial without catheter Meta-analysis
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