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Background <p>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.</p> Methods <p>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&#xa0;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 &gt; 200&#xa0;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.</p> Results <p>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&#xa0;mL vs. 402.9 ± 198.4&#xa0;mL; <i>p</i> = 0.008) and post-void residual urine volume (median 20&#xa0;mL vs. 53.5&#xa0;mL; <i>p</i> &lt; 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.</p> Conclusion <p>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.</p>

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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

  • 期刊论文

  • 发表日期：

    2026年6月20日

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  • Sujit Kumar Tripathy,
  • Paulson Varghese,
  • Shahnawaz Khan,
  • Ranjan Kumar Patel,
  • Deepak Neradi,
  • Mantu Jain

摘要

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.