Effect of Preoperative Tamsulosin on Postoperative Urinary Retention Prevention After Sling Placement: A Randomized Controlled Trial

Abstract

Introduction and Hypothesis: The objective of this study was to evaluate whether preoperative administration of tamsulosin would decrease the frequency of postoperative urinary retention (POUR) after mid-urethral sling (MUS) placement Methods: This was a prospective randomized, double-blinded, placebo-controlled trial of patients with SUI who underwent elective MUS placement at a single institution. Patients scheduled to undergo MUS placement consented, were enrolled, and were randomized to receive either a single tablet of tamsulosin 0.4 mg or placebo in the preoperative holding area on the day of their surgery. We then evaluated the rate of POUR after administration of tamsulosin compared with placebo using appropriate statistical methods. Sample size was calculated to include 160 patients. Results: A total of 161 patients (81 placebo, 80 tamsulosin) were analyzed. The incidence of POUR was similar between the tamsulosin and placebo groups (17.7% vs 19.8%, p = 0.7420). Secondary outcomes, including unplanned admissions, urinary-tract infections (UTIs), and hypotension, did not differ significantly between groups. A subgroup analysis of patients undergoing MUS without concomitant prolapse surgery suggested a trend toward lower POUR rates in the tamsulosin group (7.5% vs 16.7%, p = 0.142), although this was not statistically significant. Conclusion: These results suggest that single-dose preoperative tamsulosin might not have an effect on postoperative urinary retention after MUS placement, with or without concomitant reconstructive pelvic surgery.