A Comparison between Two Different Fixed-Dose Regimens of Terazosin on the Rates of Acute Haemodynamic Complication and Successful Trial without Catheter

Abstract

Objectives To compare the treatment with 2 mg or 4 mg terazosin once daily (an alpha-adrenergic receptor antagonist) on the success rate of trial without catheter (TWOC) and acute haemodynamic complication rate in patients with the first episode of acute urinary retention due to benign prostatic hyperplasia managed by catheterisation in the emergency department. Design Retrospective cohort study. Setting Emergency department of a regional hospital. Methods Medical records of year 2006 were reviewed. Patients taking 2 mg and 4 mg terazosin once daily were compared on the occurrence of acute haemodynamic complications (decrease in mean arterial pressure of more than 25%, orthostatic change of blood pressure of more than 20/10 mmHg or severe dizziness in the supine position) within eight hours post-treatment. The success rates of TWOC during urology follow-up (day 3 onwards) were also compared. Age and history of concurrent anti-hypertensive medication were taken as confounders and controlled. Two binary logistic regression models were applied. Results Sixty-eight patients were studied. The overall, 2 mg and 4 mg success TWOC rates were 55.6%, 44.4% and 60.0% respectively. Overall, 39.7% of the patients developed transient haemodynamic complication but none had significant adverse clinical outcome. The effects of drug dosage (p=0.271) and age (p=0.857) on the success rate of TWOC were not statistically significant. The effects of drug dosage (p=0.111), concurrent use of anti-hypertensive medication (p=0.996) and age (p=0.625) on the occurrence of haemodynamic complication were also not statistically significant. Conclusion There is no statistically significant difference between regimens of terazosin 2 mg and 4 mg once daily on the success rate of TWOC or the occurrence of acute haemodynamic complications.