876 Paediatric NG Tubes and NG Spigots – A Novel Approach to Treating Urinary Retention Secondary to Phimosis in The Emergency Department

Introduction Urinary retention due to phimosis is usually treated with an emergency dorsal slit. We present a novel approach to treating urinary retention secondary to phimosis in the emergency department. Case report We present a 53 gentleman who was seen in the emergency department due to absolute urinary retention. On review, the gentleman had a grade 5 phimosis. After several minutes of attempting to separate the edges of the forskin, a small opening was created and a size 4Fr NG paediatric NG tube was passed providing temporary relief for the patient. Once the patient was more comfortable, the narrow end of a NG spigot was used to dilate the phimosis enough for a 14Fr catheter to be passed. The patient was observed for a period of time, discharged with a trial without catheter clinic two weeks later and listed for an outpatient circumcision. Conclusions This case demonstrates a novel technique for treating urinary retention secondary to phimosis within the emergency department, avoiding the need for an emergency dorsal slit.

EFFICACY OF TAMSULOSIN IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA IN TERMS OF TRIAL WITHOUT CATHETER, A RANDOMIZED CONTROL TRIAL

BACKGROUND & OBJECTIVE: Benign prostatic hyperplasia (BPH) is a prevalent cause of voiding problems in older males and is most commonly associated with acute urological complications, most important of which is acute urinary retention (AUR). α1- antagonists are the treatment of choice for the management of patients with BPH. Our objective was to evaluate the efficacy of tamsulosin for the treatment of patients with AUR due to BPH in terms of trial without catheter (TWOC). METHODOLOGY: This randomized control trial was conducted in a Urology Section, Department of Surgery, SIUT Karachi, from 21-12-2016 to 20-06-2017. Our study included 136 patients who presented AUR due to BPH as per selection criteria. Patients were randomized into two groups. Group A patients received tamsulosin (0.4 mg), and group B patients received placebo drug immediately after insertion of Foley catheter. The success of TWOC was evaluated after 3 days of medical treatment. Statistical analysis was carried out using SPSS v20.0. RESULTS: The mean age of the study patients was 59.45 + 8.05 years. The mean duration of BPH disease was 15.39 + 6.84 months. There were 33 (48.5%) patients in the tamsulosin group in which TWOC was successful and only 22 (32.4%) patients in placebo group in which TWOC was successful (p-value 0.04). There was no effect of age and duration of BPH disease on the outcome of this study. CONCLUSION: Tamsulosin is effective for the treatment of patients with AUR due to BPH.