α1-Blockers in the management of acute urinary retention secondary to benign prostatic hyperplasia: a systematic review and meta-analysis

alpha(1)-Blockers have been widely used in the conservative management of acute urinary retention (AUR). To compare the efficacy and safety of alpha(1)-blockers in male patients with AUR secondary to benign prostatic hyperplasia (BPH). Electronic searches on PubMed/MEDLINE, EMBASE and the Cochrane Library were performed to identify all published randomized controlled trials (RCTs) and controlled clinical trials (CCTs) of alpha(1)-blockers for the treatment of AUR. Relevant reviews and reference lists of included studies were explored. Nine studies involving a total of 1051 men were enrolled in this review. Compared to 38.9 % (161/414) in control groups, 56.8 % (362/637) of patients receiving alpha(1)-blockers had a successful trial without catheter (TWOC). Meta-analysis demonstrated that alpha(1)-blockers have a substantial effect on the successful resumption of micturition after TWOC (RR = 1.45, 95 % CI 1.20-1.75, P = 0.0001). In the subsequent phase, the outcomes across studies indicated that alpha(1)-blockers may provide little benefit to maintain the satisfactory voiding without AUR recurrence or BPH surgery in a long-term follow-up. alpha(1)-Blockers were generally low and well tolerated in both phases. In conclusion, alpha(1)-blockers provide substantial benefit in increasing a satisfactory micturition within 24 h after TWOC for men with AUR due to BPH, even though the long-term effectiveness remains uncertain.