EFFECTIVENESS OF PROPHYLACTIC USE OF TAMSULOSIN FOR THE PREVENTION OF URINARY RETENTION FOLLOWING SURGERIES UNDER SPINAL ANAESTHESIA

Abstract

Background:Postoperative urinary retention (POUR) is a common complication following surgeries under spinal anesthesia, leading to patient discomfort, delayed mobilization, and increased risk of catheterization. Tamsulosin, a selective α1A-adrenergic receptor blocker, has been shown to reduce bladder outlet resistance and may help prevent POUR. Objective: To evaluate the effectiveness of prophylactic tamsulosin in preventing postoperative urinary retention in patients undergoing elective surgeries under spinal anesthesia. Methods: This prospective, observational, comparative cross-sectional study was conducted at the Department of General Surgery, GIMS, Gadag, over 18 months (August 2023–February 2025). A total of 150 patients aged 18–60 years scheduled for elective surgery under spinal anesthesia were randomly allocated into two groups. Group A received tamsulosin 0.4 mg 14 hours, 2 hours before surgery, and 6 hours postoperatively; Group B received standard preoperative care without tamsulosin. The incidence of POUR was assessed based on suprapubic discomfort, palpable mass, inability to void within 12 hours, and requirement of catheterization. Results: POUR occurred in only 1 patient (1.33%) in the tamsulosin group compared to 13 patients (17.33%) in the placebo group (p = 0.0007). Similarly, catheterization was required in 1.33% of patients in the tamsulosin group versus 17.33% in the placebo group. No statistically significant differences were noted in baseline characteristics such as age, serum creatinine, or prostate volume between the groups. Conclusion: Prophylactic administration of tamsulosin significantly reduces the incidence of postoperative urinary retention and catheterization in patients undergoing surgeries under spinal anesthesia. Its inclusion in perioperative protocols could enhance postoperative recovery and patient comfort.