Isosorbide dinitrate as an effective adjunct therapy for acute urinary retention: A randomized controlled trial

Area of Science:

• Urology
• Pharmacology

Background:

• Acute urinary retention (AUR) is a common complication of benign prostatic hyperplasia (BPH).
• Successful voiding after catheterization is crucial for patient recovery.
• Standard therapy for BPH-related AUR includes alpha-blockers and 5-alpha-reductase inhibitors.

Purpose of the Study:

• To evaluate the synergistic effect and safety of sublingual isosorbide dinitrate (ISDN) in facilitating successful voiding trials post-catheterization for AUR secondary to BPH.
• To assess ISDN's impact on post-void residual (PVR) volume and prostate-specific antigen (PSA) levels.

Main Methods:

• A randomized clinical trial involving 80 male patients aged ≥50 years with first-episode AUR secondary to BPH.
• Participants received either standard therapy alone or standard therapy plus daily sublingual ISDN (10 mg) for 21 days.
• Primary outcomes: successful voiding post-catheter removal (trial without catheter - TWOC) and PVR volume. Secondary outcomes: PSA levels and adverse events.

Main Results:

• The rate of successful TWOC was significantly higher in the ISDN plus standard therapy group (50.0%) compared to standard therapy alone (22.5%; p=0.011).
• PVR volume decreased significantly in both groups, with a greater reduction in the ISDN group (p=0.002).
• Adjunctive ISDN therapy independently predicted successful TWOC (adjusted OR 3.27; p=0.017), with no serious adverse events observed.

Conclusions:

• Adjunctive sublingual ISDN significantly improves urinary outcomes following AUR in BPH patients.
• This combination therapy effectively reduces residual urine volume and enhances TWOC success rates.
• Sublingual ISDN offers a safe and effective strategy for managing BPH-related AUR.