Kim H L, Kim J C, Benson D A, Bales G T, Gerber G S
Section Urology, Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois 60637, USA.
Tech Urol. 2001 Dec;7(4):256-60.
The aim of this study was to prospectively assess the outcome in men treated with temporary catheter drainage and tamsulosin after an episode of acute urinary retention (AUR).
Thirty-three consecutive men with AUR were treated with tamsulosin 0.4 mg daily for at least 4 days before a trial of voiding. Those men who were able to void adequately continued taking tamsulosin and were evaluated at 2-week and 3-month follow-up. After 3 months, additional follow-up was obtained at regular intervals as determined by the treating physician.
Median follow-up was 6.5 months. Mean urine volume at the time of initial bladder drainage was 790 mL. Eighty-eight percent (29/33) of men were able to void initially. Transurethral prostatectomy or intermittent catheterization were necessary in 9 (27%) of 33 patients during the follow-up period. A poor quality-of-life score on the initial International Prostate Symptom Score (p = .038) and a high postvoid residual volume 2 weeks after catheter removal (p = .013) correlated with failure of medical therapy. Patients with AUR after nonurologic surgery had a significantly better outcome than those with AUR that did not occur postoperatively. Mean symptom score, quality-of-life score, and postvoid residual urine volume were 12.9, 2.7, and 111 mL, respectively, at 2-week follow-up and were 11.9, 2.8, and 61.7 mL, respectively, at 3-month follow-up. Mean peak urinary flow rate at 3 months was 7.7 mL/s.
Tamsulosin appears to be helpful in the management of men with AUR. The majority of men were able to avoid surgery after temporary catheter drainage.
本研究的目的是前瞻性评估急性尿潴留（AUR）发作后接受临时导尿管引流和坦索罗辛治疗的男性患者的预后。
33例连续性AUR男性患者在进行排尿试验前，每天服用0.4mg坦索罗辛至少4天。那些能够充分排尿的男性继续服用坦索罗辛，并在2周和3个月随访时进行评估。3个月后，根据主治医生的决定定期进行额外随访。
中位随访时间为6.5个月。初次膀胱引流时的平均尿量为790mL。88%（29/33）的男性最初能够排尿。在随访期间，33例患者中有9例（27%）需要进行经尿道前列腺切除术或间歇性导尿。初始国际前列腺症状评分的生活质量评分较差（p = 0.038）以及拔除导尿管2周后的高残余尿量（p = 0.013）与药物治疗失败相关。非泌尿外科手术后发生AUR的患者的预后明显好于术后未发生AUR的患者。在2周随访时，平均症状评分、生活质量评分和残余尿量分别为12.9、2.7和111mL，在3个月随访时分别为11.9、2.8和61.7mL。3个月时的平均最大尿流率为7.7mL/s。
坦索罗辛似乎有助于AUR男性患者的治疗。大多数男性在临时导尿管引流后能够避免手术。
