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Tamsulosin to Prevent Postoperative Urinary Retention After Female Pelvic Reconstructive Surgery

Chapman, Graham C., MD*†‡; Sheyn, David, MD*†‡; Petrikovets, Andrey, MD*†‡; Mahajan, Sangeeta T., MD*†; El-Nashar, Sherif, MD, PhD*†; Pollard, Robert, MD*‡; Mangel, Jeffrey M., MD*‡

Female Pelvic Medicine & Reconstructive Surgery: November 9, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000650
Original Article: PDF Only
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Objective This study aimed to determine the effect of tamsulosin on postoperative urinary retention in female patients after pelvic reconstructive surgery.

Methods Data were obtained from a retrospective, matched cohort of female patients who were admitted after pelvic reconstructive surgery at a single academic institution. Patients who received tamsulosin were compared with those who did not at a 1:4 ratio, matched by surgical procedure. Patients were excluded if they were discharged on the day of surgery or if an intraoperative complication necessitated prolonged postoperative bladder drainage. Information on demographics, preoperative diagnoses, prolapse stage, preoperative voiding dysfunction, urodynamic findings, intraoperative details, postoperative complications, and voiding outcomes up to 6 weeks after surgery was gathered. The primary outcome was postoperative urinary retention, defined by failure of an active voiding trial.

Results Patients underwent surgery between January 2016 and March 2018. We identified 35 patients who received tamsulosin and matched to 140 controls. Patients in the tamsulosin group were younger; groups were otherwise similar. Patients who received tamsulosin after surgery were less likely to develop postoperative urinary retention (2.9% vs 24.3%, P = 0.004). After controlling for confounders, multivariable logistic regression identified tamsulosin use as the only independent predictor of postoperative urinary retention with a significant protective effect (odds ratio, 0.09; 95% confidence interval, 0.01–0.67; P = 0.03).

Conclusions Prophylactic tamsulosin use may be effective in preventing postoperative urinary retention in female patients undergoing pelvic reconstructive surgery.

From the *Case Western Reserve University School of Medicine, Cleveland, OH;

Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center, Cleveland, OH; and

Department of Obstetrics and Gynecology, Metrohealth Medical Center, Cleveland, OH.

Correspondence: Graham Chapman, MD, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Lakeside Bldg, Suite 4554, Cleveland, OH 44106. E-mail: graham.chapman@uhhospitals.org.

The authors have declared they have no conflicts of interest.

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