Silodosin treatment significantly increases the likelihood of successful trial without catheter (TWOC) after acute urinary retention (AUR) in men with benign prostatic hyperplasia, according to a new study.

Researchers randomized 60 men older than 50 years with AUR to receive silodosin 8 mg once daily or placebo for three days followed by TWOC. Patients who had recurrent urinary retention or post-void residual urine volume greater than 150 mL were re-catheterized and considered to have a failed TWOC. All patients with a successful TWOC on day 3 were started on silodosin regardless of which arm they had been assigned to initially. The two treatment arms were similar with respect to demographics and clinical characteristics.

The TWOC success rate was significantly greater in the silodosin than the placebo arm (76.7% vs. 36.7%), Santosh Kumar, MS, MCh, FRCS, and colleagues at the Postgraduate Institute of Medical Education and Research in Chandigarh, India, reported online ahead of print in Urology.

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In multivariable analysis, had a significant 87% decreased odds of having a TWOC failure. Among the clinical parameters, a retention volume more than 800 mL and an International Prostate Symptom Score higher than 25 prior to AUR were significantly associated with an increased risk of TWOC failure. The researchers reported no significant adverse effects with silodosin use.