RecommendationOffer an alpha blocker to men for managing acute urinary retention before removal of the catheter.
Relative values of different outcomesThe most important outcomes are to restore normal voiding and increase the chance of a successful trial without catheter without the need for re-catheterisation.
Trade off between clinical benefits and harmsThe GDG considered that men's ability to void and not being re-catheterised outweighed potential adverse events of the treatment, which includes dizziness, somnolence, postural hypotension, syncope, rhinitis, asthenia (fatigue), headache, erectile dysfunction, abnormal ejaculation.
Economic considerationsAlpha blockers can be cost-saving compared to placebo. Although the GDG considers the economic evidence to have drawbacks due to its short follow-up, it is their opinion that alpha blockers could still be cost-effective.
Quality of evidenceAll the studies were imprecise as they crossed the minimally important difference confidence intervals. The re-catheterisation outcome was low quality as there were also limitations in the study design of one of the two studies retrieved.

The economic evidence has minor limitations but partial applicability as the follow-up is very short.
Other considerationsThere is no clear evidence for how long this treatment should continue before TWOC, but it seems likely that this should be at least two days treatment before TWOC.

From: 13, Treating men with urinary retention

Cover of The Management of Lower Urinary Tract Symptoms in Men
The Management of Lower Urinary Tract Symptoms in Men [Internet].
NICE Clinical Guidelines, No. 97.
National Clinical Guideline Centre (UK).
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