Prevention of post-hysterectomy urinary retention by alpha-adrenergic blocker.

Micturition difficulties and urinary retention are common complications after abdominal or vaginal hysterectomy. Adrenergic receptors are located in the bladder neck and proximal urethra, and blocking these receptors with alpha-blockers such as phenoxybenzamine (Dibenzyline) may improve micturition and prevent postoperative urinary retention. In a randomized clinical trial, 51 patients who underwent total abdominal hysterectomy, received a prophylactic dose of Dibenzyline 10 micrograms orally 6-8 hours after operation and again the next day about 18 hours later. Only 2 of the 51 patients were found to have urinary retention, in comparison with 9 of 48 patients in the control group (p less than 0.05). Another group of patients who underwent vaginal hysterectomy were treated according to the same protocol. Eight of the 30 patients in this study group required catheterization to drain the overdistended bladder, in comparison with 16 of 26 patients in the control group (p less than 0.025). It seems from this clinical trial that prophylactic treatment with Dibenzyline is recommended after abdominal hysterectomy or vaginal operation in order to improve micturition and prevent urinary retention.