The effect of sublingual isosorbide dinitrate on acute urinary retention due to
benign prostatic hyperplasia.
Author(s): Tadayyon F, Izadpanahi M, Aali S, Mazdak H, Khorrami MH.
Affiliation(s): Department of Urology, Al-Zahra Hospital, Isfahan University of Medical Sciences,
Isfahan, Iran.
Publication date & source: 2012, Saudi J Kidney Dis Transpl. , 23(4):782-5
Acute urinary retention (AUR) is one of the most important long-term
compli-cations of benign prostatic hyperplasia (BPH). Nitric oxide (NO) as a
transmitter can relax smooth muscles of the bladder neck and external sphincter.
Several studies have reported that sublingual isosorbide dinitrate (ISDN), as a
NO donor, can lead to significant decrease in resting pressure of the external
sphincter, and its rapid onset of action may be useful in the treatment of AUR.
This study was designed to asses the effect of ISDN on AUR in patients with BPH.
In this clinical trial, 60 men with BPH-induced AUR were randomly selected via a
simple sampling method. Participants were randomly divided into case and control
groups. Patients in the case group received 200 mg of sublingual ISDN and
participants in the control group received placebo. After 20 min, participants
were asked to void spontaneously and the urine was collected in scale containers.
Following this, urethral catheterization was done on all the participants and the
residual urine was measured. Data were analyzed using SPSS version 15. There was
no signi-ficant difference in the mean age of the two groups (P-value = 0.28).
The mean voided urine volume in the case group was 201 mL and, in the control
group, it was 18 mL (P = 0.004). About 30% in the case group and 3.3% in the
control group could void spontaneously after receiving ISDN or placebo (P =
0.006). In the case group, there was a significant correlation between voided
urine volume and total urine volume in the bladder (P = 0.03) and in the size of
the prostate (P = 0.001). Our study shows that ISDN can be effective in the
treatment of BPH-induced AUR with decrease in bladder outlet resistance. ISDN is
more effective in younger men and in those with smaller prostates.
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