Use of Tamsulosin to Reduce the Incidence and Duration of Postoperative Urinary Retention Following Spine Surgery

Decompressive laminectomy and spinal fusion procedures are among the most common
neurosurgical procedures performed. Postoperative urinary retention (POUR) is a frequent
complication of such surgeries and impacts a large proportion of this population resulting in
multiple intermittent bladder catheterizations for bladder decompression, increased incidence
of bacteremia, increased incidence of UTIs, and prolonged hospital stays. Use of a
uroselective alpha-1-adrenergic receptor antagonist, such as tamsulosin, in the perioperative
period (medication started five days prior to surgery and taken until hospital discharge)
could reduce both the incidence and duration of postoperative urinary retention, resulting in
shorter hospital stays and decreased healthcare costs.

Inclusion Criteria

- ≥ 35 years (Males & Females)

- Cervical Laminectomy

- Cervical Posterior Fusion

- Cervical Anterior/Posterior Fusion

- Lumbar Laminectomy

- Lumbar Posterolateral Fusion

- Lumbar Interbody Fusion

Exclusion Criteria

- < 35 years

- Cervical Anterior Discectomy and Fusion

- Cervical Anterior Corpectomy

- Cervical Posterior Discectomy

- Cervical Foraminotomy

- Lumbar Discectomy (METRx or Open)

- Lumbar Foraminotomy

- Lumbar Anterior Fusion

- Myelopathy with bladder dysfunction

- Patients currently taking an alpha-antagonist

- Patients with history of allergy or sensitivity to tamsulosin or other
alpha-antagonist (alfuzosin, doxazosin, prazosin, terazosin, tamsulosin, and
phenoxybenzamine)

- History of prostatectomy or urologic surgery involving the bladder or urethra

- Severe liver disease or end-stage renal disease

- Patients taking strong inhibitors of CYP3A4 (ketoconazole, itraconazole,
clarithromycin, ritonavir, indinavir/ritonavir, lopinavir/ritonavir, and conivaptan)

- Patients with a mental disability

- Prisoners