Does prophylactic tamsulosin use with ERAS protocol provide improvement after colorectal surgery?

Area of Science:

• Colorectal Surgery
• Anesthesiology
• Urology

Background:

• Enhanced Recovery After Surgery (ERAS) protocols aim for faster patient recovery and reduced infection rates through early urinary catheter removal.
• However, early catheter removal can lead to urinary retention, potentially necessitating catheter reinsertion and extending hospital stays.
• Tamsulosin, an alpha-blocker, is known to effectively treat urinary retention in both sexes.

Purpose of the Study:

• To compare the incidence of urinary retention and associated short-term outcomes in patients undergoing elective abdominopelvic colorectal surgery.
• To evaluate the efficacy of postoperative tamsulosin in mitigating urinary retention within an ERAS pathway.

Main Methods:

• A retrospective cohort study involving 2072 patients undergoing elective abdominopelvic colorectal procedures under ERAS protocols (September 2020 - October 2023).
• Patients receiving postoperative tamsulosin (0.4 mg) starting April 2022 were compared to a control group.
• Propensity score matching (2:1 ratio) was employed to ensure comparability between the tamsulosin and control groups.

Main Results:

• The study included 2072 patients; propensity score matching resulted in 344 patients in the tamsulosin group and 688 in the control group.
• Patients treated with tamsulosin exhibited a significantly lower rate of urinary retention (4.7% vs. 9.2%, p=0.01).
• The length of hospital stay was also significantly shorter for patients receiving tamsulosin (4.2 days vs. 5 days, p<0.01).

Conclusions:

• Postoperative prophylactic tamsulosin administration effectively decreases urinary retention rates following colorectal surgery.
• Tamsulosin use is associated with a reduced length of hospital stay, contributing to improved patient recovery.
• Tamsulosin should be considered a valuable adjunct to ERAS protocols to enhance recovery outcomes.