Effect of Alpha Blocker (Alfuzosin) in Patients with First-Time Painful Acute Urinary Retention Secondary to Benign Prostatic Obstruction and Determinants of Failed Trial Without Catheter

Purpose: To assess the effect of the alpha blocker alfuzosin in patients experiencing their first episode of painful acute urinary retention (AUR) due to benign prostatic obstruction (BPO) and identify predictors of a failed trial without catheter (TWOC). Material and Methods: Men over 50 years presenting with spontaneous AUR related to benign prostatic enlargement (BPE) were catheterized and given 10 mg alfuzosin daily for 3 days. The primary outcome was recatheterization within 72 hours post-TWOC. We analyzed the impact of age, residual urine volume, time between retention and catheterization, functional status, and duration of lower urinary tract symptoms (LUTS). Results: Of the 104 patients initially enrolled, 100 completed the study. The mean age was 65.1 ± 9.5 years, with most patients classified as functional class I. A successful TWOC was achieved in 53% of the cases. An inverse relationship was found between LUTS duration and TWOC success (p=0.012). No significant correlation was found between TWOC success and age, time to catheterization, residual volume, or functional class. Conclusions: A single dose of 10 mg alfuzosin leads to a successful TWOC in over half of the patients. The duration of LUTS is significantly inversely associated with TWOC success.