Alfuzosin 10 mg once daily increases the chances of successful trial without catheter after acute urinary retention secondary to benign prostate hyperplasia.

OBJECTIVE: To compare the efficacy of Alfuzosin XL 10 mg once daily for the acute management of acute urinary retention (AUR) with placebo in patients with benign prostatic hyperplasia (BPH) and to determine the predictors that impact this. METHODS: 67 patients presenting with an initial episode of spontaneous AUR secondary to BPH were catheterized and were then prospectively randomized to receiving placebo or 10 mg Alfuzosin XL once daily for 2 days. The allocation and administration of treatment were double-blinded. The primary outcome measure was the rate of successful trial off catheter (TWOC) after 2 days. Clinical characteristics including intravesical prostatic protrusion (IPP) by transabdominal ultrasound were also assessed using uni- and multivariate analysis for their impact on successful TWOC. RESULTS: Three patients withdrew from the study, 2 due to adverse effects of the trial medication. Analysis on an intention-to-treat basis showed a significantly greater proportion of patients in the Alfuzosin XL group (21 of 35 or 60%) had a successful TWOC compared with patients in the placebo group (11 of 32 or 34%) (p = 0.036). Patients with grade 3 IPP (>10 mm) had a significantly lower chance of successful TWOC (p = 0.04) compared to grade 1 (10 mm are more likely to fail TWOC on Alfuzosin XL.