Evidence map›Paper›PMID 38758413›Full record

SynthesisWorld journal of urology2024

Do alpha blockers reduce the risk of urinary retention post-transperineal prostate biopsy? A systematic narrative review.

Zein Alhamdani, Samuel Poppenbeek, Damien Bolton, Lih-Ming Wong, Kapil Sethi

Abstract readSystematic Review
In one paragraph

Synthesis in World journal of urology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Zein AlhamdaniDepartment of Urology, University of Melbourne, Austin Health, 145 Studley Rd, Heidelberg VIC, Melbourne, 3084, Australia. zeinfiras@hotmail.com.ORCID http://orcid.org/0000-0002-9222-6781
Samuel PoppenbeekDepartment of Surgery, University of Melbourne, St Vincent's Health, Melbourne, Australia.
Damien BoltonDepartment of Urology, University of Melbourne, Austin Health, 145 Studley Rd, Heidelberg VIC, Melbourne, 3084, Australia.
Lih-Ming WongDepartment of Urology, University of Melbourne, Austin Health, 145 Studley Rd, Heidelberg VIC, Melbourne, 3084, Australia.
Kapil SethiDepartment of Urology, University of Melbourne, Austin Health, 145 Studley Rd, Heidelberg VIC, Melbourne, 3084, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTransperineal Prostate Biopsy (TPB) is a commonly used technique for the diagnosis of prostate cancer due to growing concerns related to infectious complications associated with transrectal ultrasound-guided prostate biopsy (TRUSB). TPB is associated with an infective complication rate of near zero, however, acute urinary retention (AUR) remains the leading complication causing morbidity. Previously in TRUSB, there was weak evidence that alpha-blockers reduce AUR rates, and their usage has been extrapolated to clinical practice with TPB. This review aims to explore if there is an evidence base for using alpha-blockers to prevent AUR following TPB.

methodsA systematic approach was used to search Ovid Medline and Embase using keywords related to "Transperineal" and "Retention". Articles were then screened by applying inclusion and exclusion criteria to find studies that compared alpha-blocker recipients to no alpha-blocker use in the perioperative period and the subsequent effect on AUR in TPB.

results361 records were identified in the initial search to produce 5 studies included in the final review. No randomised controlled trials (RCTs) were identified. One observational study showed a reduction in AUR rate from 12.5% to 5.3% with a single dose of tamsulosin. A previous systematic review of complications associated with prostate biopsy concluded there may be a potential benefit to alpha-blockers given in the TPB perioperative period. Three observational studies demonstrated a harmful effect related to alpha-blocker use; however, this was well explained by their clear limitations.

conclusionBased on this review and the extrapolation from TRUSB data, perioperative alpha-blockers may offer some weak benefits in preventing AUR following TPB. However, there is significant scope and need for an RCT to further develop the evidence base further given the significant gap in the literature and lack of a standard alpha blocker protocol in TPB.

Indexed as

PerineumProstateUrinary RetentionAdrenergic alpha-AntagonistsHumansImage-Guided BiopsyMalePostoperative ComplicationsProstatic NeoplasmsAdrenergic alpha-AntagonistsAlpha blockersSystematic reviewTransperineal Prostate biopsyUrinary retentionUro-oncology

Identifiers

PMID38758413
PMCPMC11101363

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.