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dc.creatorKaravitakis M., Kyriazis I., Omar M.I., Gravas S., Cornu J.-N., Drake M.J., Gacci M., Gratzke C., Herrmann T.R.W., Madersbacher S., Rieken M., Speakman M.J., Tikkinen K.A.O., Yuan Y., Mamoulakis C.en
dc.date.accessioned2023-01-31T08:32:04Z
dc.date.available2023-01-31T08:32:04Z
dc.date.issued2019
dc.identifier10.1016/j.eururo.2019.01.046
dc.identifier.issn03022838
dc.identifier.urihttp://hdl.handle.net/11615/74485
dc.description.abstractContext: Practice patterns for the management of urinary retention (UR) secondary to benign prostatic obstruction (BPO; UR/BPO) vary widely and remain unstandardized. Objective: To review the evidence for managing patients with UR/BPO with pharmacological and nonpharmacological treatments included in the European Association of Urology guidelines on non-neurogenic male lower urinary tract symptoms. Evidence acquisition: Search was conducted up to April 22, 2018, using CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform. This systematic review included randomized controlled trials (RCTs) and prospective comparative studies. Methods as detailed in the Cochrane handbook were followed. Certainty of evidence (CoE) was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Evidence synthesis: Literature search identified 2074 citations. Twenty-one studies were included (qualitative synthesis). The evidence for managing patients with UR/BPO with pharmacological or nonpharmacological treatments is limited. CoE for most outcomes was low/very low. Only α1-blockers (alfuzosin and tamsulosin) have been evaluated in more than one RCT. Pooled results indicated that α1-blockers provided significantly higher rates of successful trial without catheter compared with placebo [alfuzosin: 322/540 (60%) vs 156/400 (39%) (odds ratio {OR} 2.28, 95% confidence interval {CI} 1.55 to 3.36; participants = 940; studies = 7; I 2 = 41%; low CoE); tamsulosin: 75/158 (47%) vs 40/139 (29%) (OR 2.40, 95% CI 1.29 to 4.45; participants = 297; studies = 3; I 2 = 30%; low CoE)] with rare adverse events. Similar rates were achieved with tamsulosin or alfuzosin [51/87 (59%) vs 45/84 (54%) (OR 1.28, 95% CI 0.68 to 2.41; participants = 171; studies = 2; I 2 = 0%; very low CoE)]. Nonpharmacological treatments have been evaluated in RCTs/prospective comparative studies only sporadically. Conclusions: There is some evidence that usage of α1-blockers (alfuzosin and tamsulosin) may improve resolution of UR/BPO. As most nonpharmacological treatments have not been evaluated in patients with UR/BPO, the evidence is inconclusive about their benefits and harms. Patient summary: There is some evidence that alfuzosin and tamsulosin may increase the rates of successful trial without catheter, but little or no evidence on various nonpharmacological treatment options for managing patients with urinary retention secondary to benign prostatic obstruction. © 2019 European Association of UrologyAlfuzosin and tamsulosin appear to provide higher rates of successful trial without catheter. Most nonpharmacological treatment options have not been evaluated in patients with urinary retention secondary to benign prostatic obstruction. Consequently, the evidence is inconclusive regarding the efficacy of nonpharmacological interventions for the management of urinary retention secondary to benign prostatic obstruction. © 2019 European Association of Urologyen
dc.language.isoenen
dc.sourceEuropean Urologyen
dc.source.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85061427449&doi=10.1016%2fj.eururo.2019.01.046&partnerID=40&md5=16389cfe57cc6057e7498ef1d33e06ff
dc.subjectalfuzosinen
dc.subjectdoxazosinen
dc.subjectfinasterideen
dc.subjectsilodosinen
dc.subjecttamsulosinen
dc.subjectalfuzosinen
dc.subjectalpha 1 adrenergic receptor blocking agenten
dc.subjectquinazoline derivativeen
dc.subjectbenign prostatic obstructionen
dc.subjectbladder irrigationen
dc.subjectbladder trainingen
dc.subjectcatheter removalen
dc.subjectcomparative studyen
dc.subjectGRADE approachen
dc.subjecthospitalizationen
dc.subjecthumanen
dc.subjectintermittent catheterizationen
dc.subjectInternational Prostate Symptom Scoreen
dc.subjectlower urinary tract symptomen
dc.subjectmaleen
dc.subjectmeta analysisen
dc.subjectoperation durationen
dc.subjectpractice guidelineen
dc.subjectpriority journalen
dc.subjectprostate diseaseen
dc.subjectprostatectomyen
dc.subjectrandomized controlled trial (topic)en
dc.subjectrecurrence risken
dc.subjectReviewen
dc.subjectsuprapubic catheterizationen
dc.subjectsystematic reviewen
dc.subjecttransurethral microwave thermotherapyen
dc.subjecttransurethral resectionen
dc.subjecttreatment outcomeen
dc.subjecturethral catheterizationen
dc.subjecturine retentionen
dc.subjectbladder catheterizationen
dc.subjectcomplicationen
dc.subjectprostate hypertrophyen
dc.subjecturine retentionen
dc.subjectAdrenergic alpha-1 Receptor Antagonistsen
dc.subjectHumansen
dc.subjectMaleen
dc.subjectProstatectomyen
dc.subjectProstatic Hyperplasiaen
dc.subjectQuinazolinesen
dc.subjectRandomized Controlled Trials as Topicen
dc.subjectTamsulosinen
dc.subjectUrinary Catheterizationen
dc.subjectUrinary Retentionen
dc.subjectElsevier B.V.en
dc.titleManagement of Urinary Retention in Patients with Benign Prostatic Obstruction: A Systematic Review and Meta-analysisen
dc.typeotheren


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