From the Guidelines
Patients should take Flomax (tamsulosin) for at least 3-7 days after Foley catheter removal to manage urinary retention issues, with the option to extend treatment based on individual patient response. The recommended dose is 0.4 mg taken orally once daily, approximately 30 minutes after the same meal each day, preferably in the evening 1. Tamsulosin works by relaxing the smooth muscles in the prostate and bladder neck, which helps reduce urinary outflow resistance and improves voiding. This alpha-1 adrenergic blocker specifically targets receptors in the lower urinary tract with minimal effects on blood pressure. Some key considerations for treatment include:
- Starting the medication prior to attempted catheter removal, as concomitant administration of an alpha blocker is an option in patients with urinary retention 1
- Avoiding treatment in patients with a prior history of alpha-blocker side effects or unstable medical comorbidities, such as orthostatic hypertension or cerebral vascular disease 1
- Monitoring for common side effects, including dizziness, retrograde ejaculation, and orthostatic hypotension, particularly with the first dose
- Advising patients to take the first dose at bedtime and rise slowly from sitting or lying positions to minimize side effects
- Encouraging adequate fluid intake, while avoiding large amounts before bedtime
- Seeking medical attention if urinary retention persists despite medication, as recatheterization may be necessary.
From the Research
Treatment for Urinary Retention after Foley Catheter Removal
The recommended treatment for urinary retention after Foley catheter removal, specifically using Flomax (tamsulosin), is as follows:
- Tamsulosin has been shown to increase the success rates of trial without catheter (TWOC) and reduce the incidence of acute urinary retention 2, 3, 4.
- The duration of tamsulosin treatment before TWOC varies from 1 to 8 days in different studies 2, 3, 4.
- Studies have demonstrated that tamsulosin can reduce the need for re-catheterization and improve urinary symptoms in patients with acute urinary retention 2, 3, 4.
- The incidence of adverse effects, such as dizziness and somnolence, is low and similar to placebo 2, 3, 4.
Dosage and Administration
- The typical dosage of tamsulosin is 0.4 mg once daily 5, 6, 4.
- Tamsulosin can be administered orally, and its modified-release formulation allows for once-daily dosing 4.
Efficacy of Tamsulosin
- Tamsulosin has been shown to be effective in preventing post-operative urinary retention (POUR) in male patients undergoing urologic surgery under spinal anesthesia 5, 6.
- The prophylactic effects of tamsulosin on POUR are similar to those of alfuzosin, another alpha-blocker 6.
- Tamsulosin can reduce the incidence of urinary retention and the need for catheterization after urologic surgical procedures under spinal anesthesia 5, 6.