Vezhaventhan, G (2007) A Study of Alfuzosin SR in patients undergoing Trial without Catheter (TWOC) following Acute Urinary Retention due to BPH. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION : Benign prostatic hyperplasia (BPH), one of the most common diseases of aging men, can be associated with bothersome lower urinary tract symptoms (LUTS) that affect quality of life by interfering with normal daily activities and sleep patterns. The prevalence of histopathologic BPH is age dependent, with initial development usually after 40 years of age. By 60 years of age, its prevalence is greater than 50% and by age 85 is as high as 90%. Approximately one half of all men who have a histological diagnosis have moderate to severe LUTS. Because long-term data from population-based studies have only recently become available, the risks of developing complications and morbidities from untreated BPH are unclear. For example, despite recent evidence, there is still uncertainty regarding the likelihood that a patient with a specific symptom complex will develop complete urinary retention within a particular time frame. Nonetheless, BPH-associated mortality is rare and serious complications are uncommon. OBJECTIVES : To evaluate whether administration of sustained release Alfuzocin improves the outcome of Trial Without Catheter (TWOC) compared to placebo after an episode of acute urinary retention (AUR) caused by Benign Prostatic Hyperplasia (BPH), by comparing the numbers of patients who voided successfully after removing their catheter: and further comparing the recorded variables like Patient age, Initial catheterization volume after AUR, Prostate size, PVR after successful voiding between those who had a successful TWOC and those who did not and identifying whether they are influencing the success of a trial without catheter (TWOC) and subsequent failure in the follow-up period. METHODS : Between December 2004 and October 2006, 120 men aged 52–83 years (mean 64.3) presented with AUR related to Benign Prostatic Hyperplasia and a residual urine volume of 0.5–1.5 L on catheterization were enrolled in a prospective, randomized, double-blind, placebo controlled study, and randomly assigned to receive SR alfuzosin 10mg once daily (60 patients) or placebo (60 patients): the intent-to-treat (ITT) population was 120 patients. All had been admitted to hospital through the Accident and Emergency Department with AUR, and had been catheterized in the previous 72 hours. CONCLUSION : In conclusion, this study provides evidence from a randomized double-blind placebo controlled trial that an alpha-blocker, SR alfuzosin, is useful in the management of AUR related to BPH. This study shows that patients receiving SR alfuzosin were about twice more likely to void successfully than those who received placebo. In addition, it provides further evidence that the patient age (>70 years) and residual volume of AUR (>900ml) are the factors significantly affecting the outcome. While treatment with a1pha blockers may not obviate the need for surgery in all men who present with AUR, a reduction in the numbers being sent home with urinary catheters in situ is of benefit, as it may reduce subsequent perioperative morbidity and mortality, and it is more comfortable and convenient for the patients. It is clear that certain measurable parameters like advanced age and large PVR after a successful TWOC (> 150ml) may be used to identify patients at highest risk of a further episode of AUR after initial success at TWOC, who may then be offered early operative intervention.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Alfuzosin SR ; Patients ; Trial without Catheter (TWOC) ; Acute Urinary Retention ; BPH. |
| Subjects: | MEDICAL > Urology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 09 Aug 2017 04:21 |
| Last Modified: | 09 Aug 2017 04:21 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/2530 |
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