Alfuzosin 10 mg Once Daily in the Management of Acute Urinary Retention of Benign Prostatic Hyperplasia: A Double-Blind, Placebo-Controlled Study

Background: Acute urinary retention (AUR) is regarded as the most serious hazard of untreated benign prostatic hyperplasia (BPH). a-Blockers are frequently used for AUR as they have proved to be of value for successful trial without catheter (TWOC) after AUR and to decrease the need for BPH-related surgery. Objective: To evaluate the significance of alfuzosin 10 mg once daily (OD) for successful TWOC in patients with AUR and long-term management. Patients and Methods: A total of 245 enrolled AUR patients were catheterized and randomly given either alfuzosin 10 mg OD or a placebo for 3 days (first phase), all the failed patients extended their treatment for another 3 days for a second TWOC (second phase). The successful patients from both phases were again randomly given alfuzosin 10 mg OD or a placebo for 12 months, the outcomes were the recurrence of AUR or the need for surgery (third phase). Results: In the first phase, alfuzosin had a significant value for successful TWOC compared to a placebo (62.3 vs. 32.7%, p = 0.0001), in the second phase still of significance in comparison to a placebo (32.6 vs. 9.5%, p = 0.002) while in the third phase, alfuzosin compared to a placebo was of statistical significance regarding the reduction of the recurrence of AUR only in the first month (1.8 vs. 11.3%, p = 0.04) and the third month (3.7 vs. 16.9%, p = 0.02), also regarding decreasing the need for surgery it was significant only in the first month (3.7 vs. 15.0%, p = 0.04) and the third month only (7.4 vs. 20.7%, p = 0.04), respectively. This corresponds to a risk reduction of surgery in the alfuzosin group of 76% in the first month and 65% in the third month. Conclusion: Alfuzosin 10 mg OD is of value for successful TWOC after AUR, and a second trial of voiding in those who failed the first trial is recommended. It reduced the recurrence of AUR and the need of related surgery especially during the first 3 months of treatment.