LAUSR

OBJECTIVE The meta-analysis aimed to integrate the evidence of randomized control trials (RCTs) to estimate the efficacy of prophylactic tamsulosin on postoperative urinary retention (POUR). METHODS The PubMed, Embase, Web of Science and Cochrane Library databases were searched through March 1st 2022 using predetermined keywords. RCTs reporting the preventive efficacy of prophylactic tamsulosin against POUR were identified according to the PRISMA guideline. Pooled risk ratios (RRs) were calculated using a random-effects model or a fixed-effects model based on the results of heterogeneity assessment. A meta-regression analysis was performed to explore the potential sources of heterogeneity. RESULTS There were 14 studies with 1102 patients in the Tamsulosin group and 1119 patients in the Control group. The risk of POUR was significantly lower in the Tamsulosin group (156/1102 [14.2%] VS. 238/1119 [21.3%]; RR=0.65; 95% confidence interval [CI] 0.50 to 0.86; P=0.002; Heterogeneity: I2=51%; P=0.01). Tamsulosin administration was associated with a higher risk of adverse events (65/614 [10.6%] VS. 39/626 [6.2%]; RR=1.72; 95% CI 1.19 to 2.48; P=0.004; Heterogeneity: I2=0%; P=0.70). The meta-regression identified the mean age of patients as the only potential source of heterogeneity. Subgroup analysis showed that the younger patients (age <50 y) might benefit more from tamsulosin intake (RR=0.36; 95% CI 0.19 to 0.70; P=0.003; Heterogeneity: I2=49%; P=0.14). CONCLUSIONS The current meta-analysis suggested that prophylactic tamsulosin contributed to the prevention of POUR, and younger patients (<50 y) might benefit more from this preventive regimen. Tamsulosin was also associated with a higher risk of adverse events.