Efficacy and Safety of Tamsulosin in the Prevention of Postoperative Urinary Retention in Hip Fractures (TamPOUR-Hip Trial): A Randomized, Double-Blind Placebo-Controlled Study.
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引用次数: 0
Abstract
Background: Postoperative urinary retention (POUR) is a common problem after hip fracture surgery in the elderly patients, leading to increased morbidity, catheterization, and prolonged hospitalization. Tamsulosin, an α1-adrenergic antagonist, may reduce POUR by decreasing bladder outlet resistance. This study evaluated the efficacy and safety of perioperative tamsulosin in preventing POUR in hip fracture patients.
Methods: In this prospective, randomized, double-blind, placebo-controlled trial, 120 patients undergoing hip fracture surgery under spinal anaesthesia were allocated to receive either tamsulosin (0.4 mg daily) or placebo from admission until the second postoperative day. Foley catheter was removed on postoperative day one, and POUR was defined as post-void residual urine > 200 mL at six hours of catheter removal. Primary outcome was incidence of POUR; secondary outcomes included indwelling re-catheterization rates, urinary tract infections (UTIs), and adverse events.
Results: POUR was observed in 16.7% of patients in the tamsulosin group compared with 33.3% in the placebo group. Tamsulosin significantly reduced the pre-void bladder volume (311.3 ± 174.5 mL vs. 402.9 ± 198.4 mL; p = 0.008) and post-void residual urine volume (median 20 mL vs. 53.5 mL; p < 0.001). Re-catheterization was less frequent with tamsulosin (8.3% vs. 21.7%), though not statistically significant. Multivariate logistic regression analysis identified female sex, longer surgical duration, and blood loss as independent risk factors for POUR, while tamsulosin use was not found to be preventive. Adverse events, including dizziness and postural hypotension, were mild and self-limiting.
Conclusion: Perioperative tamsulosin was safe and improved bladder emptying, but did not significantly reduce the incidence of POUR in elderly patients undergoing hip fracture surgery. Larger multicentric studies are needed to further clarify its role in this population.
期刊介绍：
IJO welcomes articles that contribute to Orthopaedic knowledge from India and overseas. We publish articles dealing with clinical orthopaedics and basic research in orthopaedic surgery. Articles are accepted only for exclusive publication in the Indian Journal of Orthopaedics. Previously published articles, articles which are in peer-reviewed electronic publications in other journals, are not accepted by the Journal. Published articles and illustrations become the property of the Journal. The copyright remains with the journal. Studies must be carried out in accordance with World Medical Association Declaration of Helsinki.
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