Incontinence & Female Urology & Neurourology(구연) (NP-005) 하지관절치환술 후 요폐발생에 대한 탐슐로신의 예방효과: 전향적 무작위 대조연구 한림대학교 의과대학 비뇨의학과 교실 김의석, 최창일, 김종근, 추민수, 이성호, 한준현 Objective: Acute postoperative urinary retention (POUR) is a common surgical complication. The estimated incidence after general surgery is 2.1–36.6%, but the incidence after lower limb arthroplasty is reported to be 20 times greater than after other procedures. The aim of this study was to investigate effects of alpha-blocker treatment on prevention for postoperative urinary retention after lower limb arthroplasty. Methods: Of the patients hospitalized for lower limb arthroplasty, patients with primary total hip or knee arthroplasty over the age of 18 were included. All eligible patients were randomly assigned and medication (0.2 mg of tamsulosin) was administered orally once at night to patients in the treated group for 3 days from the first postoperative day. The Foley catheter was kept indwelling for 3 days postoperatively. The primary end point was the incidence of POUR according to the tamsulosin treatment after lower limb arthroplasty. POUR was defined as clinical evidence of a distended bladder, with inability to void or incomplete emptying despite a desire to void, accompanied by bladder pain or discomfort persisting at least 4 hours after urinary catheter removal. In patients with no sensation of the need to void for 6 hours after Foley catheter removal, the residual urine volume was checked with bladder ultrasound and then, catheterization was performed if the residual urine volume was over 400 mL. These patients were also considered to have POUR. Results: A total of 100 patients were enrolled, and data of 95 patients were included in the analysis. Of the 95 patients who underwent lower limb arthroplasty, 20 patients (21.1%) were diagnosed with POUR. Six out of 48 patients (12.5%) in the treated group and 14 out of 47 patients (29.8%) in the non-treated group developed POUR after hip or knee arthroplasty procedure. The probability of POUR was 0.337 times lower with tamsulosin treatment after lower limb arthroplasty (95% CI 0.117-0.971; P=0.044). After adjusting for the effects of potential covariates, tamsulosin treatment was also associated with lower the risk of POUR (OR 0.250, 95% CI 0.069-0.905, P=0.038). Conclusions: Postoperative tamsulosin treatment decreasd the probability of acute postoperative urinary retention on the patients who underwent lower limb arthroplasty after urinary catheter removal. keywords : Urinary Retention, Arthroplasty, Tamsulosin