https://doi.org/10.4081/aiua.2026.15967
Efficacy and safety of α1-adrenergic receptor antagonists in managing acute urinary retention secondary to benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials
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Accepted: 6 September 2026
Published: 28 September 2026
Objective(s): Acute urinary retention (AUR) is a common consequence of progressive symptoms in patients with benign prostatic hyperplasia (BPH), with an incidence of approximately 6.8 episodes per 1,000 individuals per year. This study aims to evaluate the effectiveness of α1-adrenergic receptor antagonists in improving the success rate of trial without catheter (TWOC) following episodes of AUR.
Material and method(s): This systematic review and meta-analysis were conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) 2020 statement, and the protocol was registered in PROSPERO (ID: CRD420251127772). A detailed literature search was run in PubMed, Cochrane Library (CENTRAL), and Google Scholar.
Result(s): The meta-analysis of 8 randomized controlled trials showed that treatment with α1-adrenergic receptor antagonists significantly improved the likelihood of successful trial without catheter (TWOC) as compared with placebo, with a pooled risk difference of 24.5% (95% CI: 18.4-30.7, p < 0.0001).
Conclusions: α1-Adrenergic receptor antagonist therapy significantly improves short-term voiding success following AUR due to BPH and appears to reduce recurrence without a significant increase in adverse events. These findings support the routine use of α1-blockers as part of initial management before TWOC in men with AUR secondary to BPH.
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Ethics Approval
CRediT authorship contribution
GSA, study concept and design, project administration, literature search, study selection, data extraction, formal analysis, validation, manuscript original drafting, manuscript writing and editing, references arrangement, cover letter preparation, manuscript submission. BMA, study design, literature search, study selection, data extraction, formal analysis, data interpretation, visualization, drafting of the Results section, manuscript writing and editing, critical revision. MAA, study selection, risk of bias assessment, validation, drafting of the Methods and Discussion sections, manuscript writing and editing, journal selection. HA, study selection, data interpretation, validation, drafting of the Introduction and Abstract, manuscript writing and editing, critical revision.AMA, data extraction, formal analysis, validation, manuscript writing and editing.KH, study concept and design, project administration, supervision, data interpretation, journal selection, manuscript writing and editing, critical revision, validation. All authors read and approved the final version of the manuscript and agreed to be accountable for all aspects of the work.
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Data Availability Statement
All data generated or analyzed during this study are included in this published article.
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