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[Sacral neuromodulation in patients with nonobstructive, chronic urinary retention: relevance of the carbachol test and influence of associated nerve lession].

OBJECTIVE: Aim of this study was to evaluate whether the carbachol test and the nerve lesions responsible for bladder dysfunction possess predictive value in patients with chronic urinary retention who undergo temporary sacral neuromodulation (PNE test). MATERIAL AND METHODS: In 1999 and 2000, PNE tests were performed in 24 patients with chronic urinary retention and acontractile detrusor previously assessed by urodynamics. In 18 patients, a carbachol test was performed during urodynamics. The diagnosis related to the acontractile detrusor was additionally assessed and compared to the successful outcome of the PNE test. RESULTS: The PNE test was successful in 8 of the 24 patients (33.3 %). The bladder was completely emptied during the PNE test in 3 of the 10 patients with negative carbachol test and in 3 of the 8 patients with positive carbachol test. The highest success rate (80 %) was observed in patients after hysterectomy, whereas after lumbosacral pulposal prolapse or with a CNS tumor, it was only 20 - 33.3 %. CONCLUSIONS: We conclude that sacral neuromodulation is an effective treatment option in patients with nonobstructive urinary retention. The carbachol test does not possess any definitive predictive value with respect to the success rate of sacral neuromodulation in patients with chronic urinary retention. The success rate more likely depends on the localisation of the nerve lesion. PNE tests should be performed in all patients with therapy resistent nonobstructive urinary retention, as no other predictive factors exist.

Adult↗

Factors that are associated with clinically overt postpartum urinary retention after vaginal delivery.

OBJECTIVE: This study was undertaken to determine the incidence of clinically overt postpartum urinary retention after vaginal delivery and to examine what maternal, fetal, and obstetric factors are associated with this problem. STUDY DESIGN: This was a retrospective case-controlled study of women who had overt postpartum urinary retention after vaginal delivery from August 1992 through April 2000. RESULTS: Fifty-one of 11,332 (0.45%) vaginal deliveries were complicated by clinically overt postpartum urinary retention. In most cases (80.4%), the problem had resolved before hospital dismissal. Persons with urinary retention were more likely than control subjects to be primiparous (66.7% vs 40.0%; P <.001), to have had an instrument-assisted delivery (47.1% vs 12.4%; P <.001), to have received regional analgesia (98.0% vs 68.8%; P <.001), and to have had a mediolateral episiotomy (39.2% vs 12.5%; P <.001). On multivariate logistic regression analysis, of these 4 variables, only instrument-assisted delivery and regional analgesia were significant independent risk factors. CONCLUSION: Clinically overt postpartum urinary retention complicates approximately 1 in 200 vaginal deliveries, with most resolving before hospital dismissal. Factors that are independently associated with its occurrence include instrument-assisted delivery and regional analgesia.

Adult↗

When forgetting benefits motor retention.

Recent research (Lee & Weeks, 1987; Weeks, Lee, & Elliott, 1987) investigating the processes responsible for the contextual interference phenomenon has used a modified short-term motor retention paradigm to support the reconstruction explanation (Lee & Magill, 1985; Magill, 1989; Magill & Hall, 1990). The present experiment was an extension of these experiments in which forgetting of an acquisition task was induced through performance of either a similar or dissimilar distractor task during the intertrial interval. The effects of an extra practice trial with the acquisition task as well as no activity during the intertrial interval were also investigated. In addition, forgetting of the acquisition task was assessed prior to a reconstruction trial, which immediately preceded a 2-min filled retention interval. Both similar and dissimilar distractor tasks caused equivalent amounts of forgetting of the acquisition task prior to the reconstruction trial. However, retention of the acquisition task was significantly improved if its reconstruction occurred following forgetting due to interference from performance of a similar distractor task. These findings suggest forgetting and subsequent reconstruction alone are not sufficient for improved retention. These processes must occur in the context of a similar task for improved retention.

Analysis of Variance↗

Effects of repeated retention tests on learning a single timing task.

The purpose of the present study was to investigate the possibility that administering an initial retention test would influence any subsequent retention tests administered to the same participants. Participants performed 40 practice trials of a four-segment key-pressing task with a movement time goal of 925 ms. Participants were then administered either two retention tests (Day 1-Day 1 group, 10 min and 20 min after practice; Day 1-Day 2 group, 10 min and 24 hr after practice; Day 2-Day 2 group, 23 hr 50 min and 24 hr after practice) or one retention test (Day 1-Control group, 20 min after practice; Day 2-Control group, 24 hr after practice). The first test had a deleterious effect on performing the second test for the Day 2-Day 2 group, which would be expected if the task representation was updated and re-encoded at the time of recall using diminished information. This finding suggests that researchers should be cautious about using repeated retention tests that are administered 1 day after practice. In addition, teachers and coaches should consider administering a test under gamelike conditions following practice of a new technique. Otherwise, performance of the new technique may be degraded or perturbed at the time of later performances.

Humans↗

Tolerability of acute postoperative pain management: nausea, vomiting, sedation, pruritus, and urinary retention. Evidence from published data.

This review examines the evidence from published data concerning the tolerability (indicated by the incidence of nausea, vomiting, sedation, pruritus, and urinary retention), of three analgesic techniques after major surgery; intramuscular analgesia (i.m.), patient-controlled analgesia (PCA), and epidural analgesia. A MEDLINE search of publications concerned with the management of postoperative pain and these indicators identified over 800 original papers and reviews. Of these, data were extracted from 183 studies relating to postoperative nausea and vomiting, 89 relating to sedation, 166 relating to pruritus, and 94 relating to urinary retention, giving pooled data which represent a total of more than 100,000 patients. The overall mean (95% CI) incidence of nausea was 25.2 (19.3-32.1)% and of emesis was 20.2 (17.5-23.2)% for all three analgesic techniques. PCA was associated with the highest incidence of nausea but the emesis was unaffected by analgesic technique. There was considerable variability in the criteria used for defining sedation. The overall mean for mild sedation was 23.9 (23-24.8)% and for excessive sedation was 2.6 (2.3-2.8)% for all three analgesic techniques (significantly lower with epidural analgesia). The overall mean incidence of pruritus was 14.7 (11.9-18.1)% for all three analgesic techniques (lowest with i.m. analgesia). Urinary retention occurred in 23.0 (17.3-29.9)% of patients (highest with epidural analgesia). The incidence of nausea and excessive sedation decreased over the period 1980-99, but the incidence of vomiting, pruritus, and urinary retention did not. From these published data it is possible to set standards of care after major surgery for nausea 25%, vomiting 20%, minor sedation 24%, excessive sedation 2.6%, pruritus 14.7%, and urinary retention requiring catheterization 23%. Acute Pain Services should aim for incidences less than this standard of care.

Analgesia↗

Elevated intron retention implicates neuroinflammation in brains of individuals with alcohol use disorder.

Intron retention, a form of alternative RNA splicing, can occur as part of normal gene regulation or result from disruption of the splicing machinery. Retained introns can potentially form double-stranded RNA, activating innate immune sensors and inflammation. This mechanism has been implicated in cancer but has not been studied in neuropsychiatric diseases like alcohol use disorder. We systematically analysed transcriptome-wide intron retention events in post-mortem brain tissue from 142 individuals (66 with alcohol use disorder and 76 controls), encompassing 320 region-specific samples from the superior frontal cortex, nucleus accumbens, central nucleus and basolateral amygdala. Analyses were adjusted for demographic, technical and biological covariates. Validation was performed in alcohol-preferring (P) rats using long-read sequencing. In complementary experiments, immunofluorescent staining was used to detect double-stranded RNA in rat brain tissue, while single-cell RNA-sequencing was performed to test activation of double-stranded RNA-sensing pathways in human brains. Brains from individuals with alcohol use disorder showed significantly higher total intron retention compared with controls, independent of age, with females showing greater increases than males. A total of 368 introns were positively associated with alcohol use disorder, and these introns were significantly longer and had weaker splice acceptor sites compared with non-associated introns. Genes harbouring these intron retention events were enriched in Purkinje neurons, visual cortex neurons and oligodendrocytes. Computational predictions indicated these long introns could form duplex RNA structures. Increased double-stranded RNA was confirmed experimentally in multiple brain regions of alcohol-consuming rats, where it co-localized primarily with neuronal nuclei and dendrites. In individuals with alcohol use disorder, we found that multiple pathways including double-stranded RNA responses, neuroinflammation, interferon and NF-&#x3ba;B signalling, adaptive immunity and apoptosis were activated. In addition, NeuN-positive neuronal counts significantly decreased in both the prefrontal and visual cortices. Furthermore, single-cell analysis demonstrated upregulation of TICAM1, the target of double-stranded RNA sensor TLR3, in oligodendrocytes, as well as widespread activation of downstream inflammatory pathways across glial and neuronal cell types. These findings provide the first evidence that chronic alcohol consumption promotes an overall increase of intron retention in the brain and is associated with the presence of double-stranded RNA. Furthermore, the double-stranded RNA may contribute to neuronal loss and brain pathology by activating a neuroinflammatory response.

alcohol use disorder↗

Retention of words in long-term memory: a functional neuroanatomical study with PET.

We used PET to identify brain regions associated with retention of verbal materials in long-term memory. During a PET scan, subjects repeated many sets of words one after another. In a retention condition, they were simultaneously required to retain 10 key words that were irrelevant to the repetition task. Significant increases in regional cerebral blood flow during the retention condition were found in bilateral parahippocampal regions, the left prefrontal and parietal association cortices, the supplementary motor area, the neostriatum and the cerebellum. We clearly demonstrated that retention of verbal materials was accompanied by neural activities in the medial temporal lobes. We also showed that, in the early phase, retention of words in long-term memory recruited left cortical areas surrounding those relevant to verbal short-term memory.

Acoustic Stimulation↗

Holmium laser enucleation of the prostate for men with urinary retention.

PURPOSE: Holmium laser enucleation of the prostate (HoLEP) is an established procedure for the treatment of patients with benign prostatic hyperplasia. We performed a study to examine a group of patients in urinary retention treated by HoLEP. MATERIALS AND METHODS: A retrospective analysis of 164 consecutive patients with urinary retention who underwent HoLEP between January 2000 and August 2004 was performed. RESULTS: Mean patient age was 72.1 years (range 34 to 95). Mean duration of urinary retention was 28.9 days (range 2 to 365). Mean preoperative transrectal ultrasound measured prostate volume was 107.1 cc (range 5 to 242). Mean weight of resected tissue was 81.9 grams (range 2.5 to 271). Mean duration of postoperative catheterization and hospitalization was 22.5 hours (range 2 to 240) and 33.7 hours (range 2 to 144), respectively. All patients were able to void following treatment and remain catheter free. CONCLUSIONS: HoLEP is an effective treatment, with low morbidity, for patients with urinary retention. These results suggest that HoLEP may be the ideal treatment for men with urinary retention due to benign prostatic obstruction.

Adult↗

Can alpha-blocker therapy be an alternative to biofeedback for dysfunctional voiding and urinary retention? A prospective study.

PURPOSE: Traditional treatment of dysfunctional voiding in children with urinary retention involves retraining the pelvic floor muscles using biofeedback. Alpha-blockers are reported to also be effective in children with urinary retention and dysfunctional voiding. We compared the efficacy of biofeedback and alpha-blockers for dysfunctional voiding and urinary retention in terms of residual urine volume and urge incontinence episodes, mean flow rates and urinary tract infections. MATERIALS AND METHODS: A total of 28 patients with a mean age of 6.25 years (range 4 to 10) presented with symptoms of urinary incontinence, urgency and urinary tract infections without anatomic and neurogenic causes of urinary retention. All patients had increased post-void residual (PVR) urine volume (mean 59 ml, 32% of age expected capacity [AEC]). The biofeedback group consisted of 16 children (mean age 6.5 years) and the alpha-blocker group consisted of 12 children (mean age 5.9 years). Both groups were also on continued timed voiding, constipation treatment and anticholinergics, which had been used for at least the last 6 months. Biofeedback (median 10, range 6 to 16 sessions) and doxazosin (0.5 to 2 mg) were administered. At 3 and 6 months incontinence episodes, urinary tract infections, mean urinary flow rates, PVR and parental satisfaction grades (1 to 10) were reevaluated. Six refractory cases were started on alpha-blockers and biofeedback, and reevaluated after 1 month and 3 months. RESULTS: Pretreatment mean PVR was 54 ml (30% of AEC), and mean posttreatment PVR was 21 ml (12% of AEC) and 9 ml (5% of AEC) at 3 and 6 months in the biofeedback group (p <0.05). Pretreatment mean PVR was 64 ml (38% of AEC), and posttreatment mean PVR was 17 ml (12% of AEC) and 13 ml (8% of AEC) at 3 and 6 months in the alpha-blocker group (p <0.05). There was no statistical difference in posttreatment PVR between the 2 groups (p >0.05). High PVR persisted in 4 (25%) biofeedback cases and in 2 (16%) alpha-blocker cases. Complete improvement in urge incontinence episodes occurred in 10 (62.5%) and 7 (70%) children in the biofeedback and alpha-blocker groups, respectively. In therapy responsive children parental satisfaction was higher with alpha-blocker than with biofeedback (9.2 vs 7.9, p <0.05). Refractory high PVR decreased significantly after combination treatment with biofeedback and alpha-blocker in 5 of 6 children (mean 80 ml, 35% of AEC vs mean 15 ml, 7% of AEC). No drug related side effect was reported in the alpha-blocker group. CONCLUSIONS: Alpha-blocker therapy seems to be a viable alternative to biofeedback in dysfunctional voiding in children with urinary retention to improve bladder emptying. Combination treatment (biofeedback and alpha-blockers) can be used as additional therapy in refractory cases.

Adrenergic alpha-Antagonists↗

The influence of surface roughness on the retentive ability of two dental luting cements.

Two series of brass cones and two series of dentine posts with varying surface roughness were produced. Maximum roughness value and arithmetical mean roughness were recorded for each cone. Brass crowns were cemented either with zinc phosphate cement (De Trey's zinc Cenment Improved) or with polycarboxylate cement (Durelon). A tensile stress was applied until the crown and the cone separated. The retentive force in relation to retention area was measured. The results showed that the retentive ability of both cements increased with increasing surface roughness. The increase in retention was greater for brass than for dentine. Differences were also found between the two cements; on smooth surfaces the zinc phosphate cement had a lower retentive ability than the polycarboxylate cement, but on rough surfaces the opposite relationship was observed.

Acrylic Resins↗

Retention force and fatigue strength of overdenture attachment systems.

This study evaluated retention force and fatigue resistance of two overdenture attachment systems. Twenty samples (O-ring and Bar-Clip) from two manufacturers (Conexão Sistemas de Prótese and Lifecore Biomedical) were prepared and divided into four groups: (i) Conexão/O-ring; (ii) Conexão/Bar-Clip; (iii) Lifecore/O-ring and (iv) Lifecore/Bar-Clip, with five samples in each group. They were submitted to mechanical fatigue test using a servohydraulic machine performing 5500 cycles of insertion and removal (f=0.8 Hz), immersed in artificial saliva. Retention force values were obtained three times (0, 3000 and after 5500 cycles) simulating the clinical service, using a tensile strength at 1 mm min(-1) and load cell of 1 kN. Data were analysed with analysis of variance and Tukey's test at 5% level. Results showed that Conexão/Bar-Clip specimens had significantly higher retention values than Lifecore/Bar-Clip (44.61 and 18.44 N, respectively), Conexão/O-ring specimens had significantly lower values than Lifecore/O-ring (13.91 and 19.75 N, respectively). Conexão/Bar-Clip values were always significantly higher than those of Conexão/O-ring group (44.61 and 13.91 N, respectively). Lifecore (O-ring and Bar-Clip) presented similar values (19.75 and 18.44 N, respectively). The systems evaluated showed satisfactory retention force values, before and after fatigue testing. Conexão/Bar-Clip specimens presented the highest values. A 5-year simulation of insertion and removal did not decrease retention values or fracture components.

Dental Implants↗

Effect of preparation convergence on retention and seating discrepancy of complete veneer crowns.

The purpose of this study was to evaluate the retention and marginal seating discrepancy of complete veneer crown cemented with zinc phosphate cement using various preparation convergence designs. The method employed was that of cementing cast metal crowns onto 46 metal dies fabricated as complete veneer crown preparations with various convergence angles ranging from 0 degrees to 70 degrees and a shoulder finish line. The marginal discrepancy was calculated by measuring the change in crown height before and after cementation using an optical measuring microscope. The force required to remove the crowns from the dies in a vertical direction was determined using an Instron universal testing machine and recorded as retention. The increase in preparation convergence exhibited a wide variation of seating discrepancy between specimens, ranging from 4.58 +/- 1.13 to 73.13 +/- 78.32 microm. Significant tilting of crown was observed as the convergence angle of preparation increased. The retention values ranged from 4.03 +/- 0.61 to 12.12 +/- 0.33 MPa. The Pearson analysis revealed statistically significant correlations between preparation convergence and marginal discrepancy (r = +0.62), and retention (r = -0.91). Crown retention and marginal discrepancy were influenced by the preparation convergence design.

Cementation↗

Effect of preparation convergence on retention and seating discrepancy of complete veneer crowns.

The purpose of this study was to evaluate the retention and marginal seating discrepancy of complete veneer crown cemented with zinc phosphate using various preparation convergence designs. The method employed was that of cementing cast metal crowns onto 46 metal dies fabricated as complete veneer crown preparations with various convergence angles ranging from 0 degrees to 70 degrees and a shoulder finish line. The marginal discrepancy was calculated by measuring the change in crown height before and after cementation using an optical measuring microscope. The force required to remove the crowns from the dies in a vertical direction was determined using an Instron universal testing machine and recorded as retention. The increase in preparation convergence exhibited a wide variation of seating discrepancy between specimens, ranging from 4.58 +/- 1.13 to 73.13 +/- 78.32 microm. Significant tilting of crown was observed as the convergence angle of preparation increased. The retention values ranged from 4.03 +/- 0.61 to 12.12 +/- 0.33 MPa. The Pearson analysis revealed statistically significant correlations between preparation convergence and marginal discrepancy (r = +0.62), and retention (r = -0.91). Complete veneer crown retention and marginal discrepancy were influenced by the preparation convergence design.

Cementation↗

Retention for a removable partial denture.

This article addresses the complex nature of retention in a removable partial denture. Retentive features range from magnets and springs to clips, clasps, and interfacial surface tension. The retentive quality of an extracoronal clasp varies with the alloy, physical form, location on the abutment, and positional relationship to other elements. Surveying to identify both occlusogingival and mesiodistal undercuts when the path of random dislodging forces are not definitely controlled is needed for effective retention. Augmentation of ineffective retention in existing clasps should concentrate on methods of deepening the undercut or increasing the suprabulge. Tightening of clasps already in contact with a tooth frequently produces adverse changes.

Dental Abutments↗

Retention characteristics of attachment systems for implant overdentures.

PURPOSE: The aim of this study was to compare the retention characteristics of various overdenture attachment systems commonly used to retain overdentures to dental implants. MATERIALS AND METHODS: An edentulous mandibular model was constructed incorporating 2 parallel 4.0 mm x 13 mm Branemark implants placed in the canine regions. Attachments were embedded in a metal-reinforced experimental overdenture designed to be dislodged from the model by a universal testing machine. Tensile dislodging force was applied to the overdenture at a cross-head speed of 50 mm/min. Five overdentures were constructed for each of the attachment systems. The attachments evaluated were the Hader bar & metal clip, Locator LR pink, Locator LR white, Spheroflex ball, Shiner magnet, Maxi magnet, Magnedisc magnet, ERA white, and ERA gray. Each apparatus was tested with 5 specimens per attachment system. Peak load-to-dislodgement was measured. Analysis of variance and Scheffe multiple comparison tests were applied to the data with alpha< or = 0.05 level of significance. RESULTS: Peak load-to-dislodgement for all attachment systems ranged from 3.68 +/- 1.32 N to 35.24 +/- 1.99 N. Strain-at-dislodgement, calculated from stress-strain curves, ranged from 0.78 +/- 0.20% to 2.78 +/- 0.5%. The ERA gray attachment demonstrated the greatest retention, with a peak load-to-dislodgement of 35.24 +/- 1.99 N, and a relatively low strain-at-dislodgement of 1.64 +/- 0.09%. Less retention was recorded for the Locator LR white, Spheroflex ball, Hader bar & metal clip, and ERA white systems. The Locator LR pink attachment demonstrated still less retention with a load-to-dislodgement of 12.33 +/- 1.28 N. Significantly high strain-at-dislodgement was recorded for the Hader bar & metal clip and Locator nylon attachment systems. The lowest dislodging loads and strains were recorded for the Shiner magnet, Maxi magnet, and Magnedisc magnet attachments. CONCLUSIONS: Results suggest that the attachment systems evaluated may be grouped into high (ERA gray), medium (Locator LR white, Spheroflex ball, Hader bar & metal clip, ERA white), low (Locator LR pink), and very low (Shiner magnet, Maxi magnet, Magnedisc magnet) retention characteristics.

Analysis of Variance↗

Retentive strength of metal copings on prefabricated abutments with five different cements.

BACKGROUND: Despite their wide use in implant dentistry, there is insufficient information concerning the retentive strength of cement-retained superstructures. PURPOSE: This study compared the retentive strength of metal copings on prefabricated abutments with five different luting cements. MATERIALS AND METHODS: Eight prefabricated abutments were placed on titanium screw implants torqued to 35 Ncm. Metal copings were cast with Au-Pt-Pd alloy (DeguDent Universal, Degussa, Hanau, Germany) using burnt-out plastic copings. Cements used were zinc oxide-eugenol-free temporary (ZO), zinc phosphate (ZP), glass ionomer (GI), resin-reinforced glass ionomer (RG), and composite resin (CR) cements. Retentive strength was measured with a universal testing machine. The means of each group were compared by one-way analysis of variance and Tukey-Kramer multiple-comparison intervals at a significance level of p < .05. RESULTS: The mean +/- SD retentive strength of the cements in Newtons was ZO 56 +/- 12 (Tukey group C), ZP 158 +/- 79 (Tukey group B), GI 132 +/- 29 (Tukey group B), RG 477 +/- 52 (Tukey group A), and CR 478 +/- 50 (Tukey group A). CONCLUSION: The retentive strength of metal copings on implant abutments is somewhat different from those of conventional cemented restorations on natural teeth. These differences may be influenced by differences in surface roughness and the height of the abutment.

Composite Resins↗

Retentive properties of three post-core systems.

The retention in root canals of Flexi-Posts, Para-Posts and Brasseler/Vlock-Posts was measured using tensile and compressive/shear forces. Forty-two extracted maxillary anterior teeth were embedded in self-curing acrylic resin and treated endodontically. Each root canal was prepared with the appropriate matching drills for the post-core system chosen. Each post-core was cemented in the canal with zinc phosphate cement. A tensile force was applied along the long axis of each tooth and the force needed to dislodge the post-core was recorded. There was no difference in retention between the small diameter posts, but the difference between the medium and the large diameter posts, however, was significant. In the medium diameter post group, the Flexi-Post was approximately twice as retentive as the other two post-core systems evaluated. In the second series of tests compressive/shear force was applied at an angle of 130 degrees to the long axis of the tooth. The retention difference between the small diameter posts was found to be statistically significant, Flexi-Posts being more retentive than Para-Posts and B/V-Posts.

Dental Prosthesis Retention↗

Urinary retention in patients with BPH treated with finasteride or placebo over 4 years. Characterization of patients and ultimate outcomes. The PLESS Study Group.

OBJECTIVES: Knowledge regarding the incidence and prevalence of acute urinary retention and the ultimate outcome is very limited. The purpose of the present analysis was to document the natural history and outcomes of acute urinary retention (AUR) further specified as being either precipitated or spontaneous, and to evaluate the potential benefit of finasteride therapy. MATERIALS AND METHODS: Three thousand and forty men with moderate to severe symptoms of BPH and enlarged prostate glands by digital rectal examination were enrolled into the 4-year placebo-controlled PLESS trial and were evaluated for occurrences of AUR and BPH-related surgery. Men in the study were seen every 4 months; discontinued patients were followed up 6 months after discontinuation and again at the end of the 4-year trial. Complete 4-year data on outcomes (occurrence of AUR or BPH-related surgery) was available for 92% of the enrolled subjects in each treatment group. An endpoint committee, blinded to treatment group and center, reviewed and categorized all study-related documentation relating to retention and surgery. RESULTS: Over the 4-year period, 99 of 1,503 placebo-treated patients (6.6%) experienced one or more episodes of AUR in comparison with 42 or 1,513 finasteride-treated patients (2.8%; p<0. 001). Approximately half of the episodes of retention were spontaneous and clearly BPH-related, while the other episodes were precipitated by another factor (PAUR). After spontaneous AUR, subsequent surgery was performed in 39 of 52 (75%) placebo-treated patients versus 8 of 20 (40%) finasteride-treated patients (p = 0. 01). BPH-related surgery was less common in men who had a prior episode of PAUR (26% in the placebo group and 14% in the finasteride group). CONCLUSION: There is a continual risk of spontaneous and precipitated acute urinary retention in men with moderate to severe lower urinary tract symptoms and an enlarged prostate gland. Fewer patients who developed precipitated AUR than spontaneous AUR go on to need subsequent BPH-related surgery. Significantly fewer finasteride-than placebo-treated patients developed AUR, and among those men, fewer ultimately needed BPH-related surgery.

Finasteride↗