Post Operative Urinary Retention (POUR) Following Thoracic Oncological Surgery

NCT05657990 | Recruiting Early Phase 1 FDA Drug

• 1 other identifier: Pro2022-0489
• Study Type: interventional
• Target: 46
• Locations: 1 country
• Sites: 4

Brief Summary

This is a feasibility study looking at whether the use of Tamsulosin could lower the high incidence of postoperative urinary retention (POUR) in older men who undergo an oncological thoracic surgical procedure for suspected or confirmed cancer. In addition, the study will try to identify the time of resumption of presurgical urinary function post Tamsulosin administration.

Conditions

Urinary Retention

Keywords

Urinary Retention; post surgery Urinary Retention; thoracic surgery; spontaneous voiding; bladder retention; Tamsulosin (FlomaxTM); kidney injury; men undergoing thoracic oncological surgical procedure; BladderScanner

Outcome Measures

Primary Outcomes (5)

• Number of participants that were able to spontaneously void after surgery completion

  Self-reported void within 6-8 hours post operative

  6-8 hours post operative

• Time of the void

  Time (number of minutes) to first postoperative spontaneous urination post operation

  Within 24 hours post operative

• Volume of urine

  Volume of urine during the first postoperative spontaneous urination post operation.

  Within 24 hours post operative

• Amount of residual urine

  Patients will receive a bladder scan post their first postoperative spontaneous urination and the amount of residual urine will be measured.

  Within 24 hours post operative

• Number of participants that needed an intervention due to failure to spontaneously urinate

  Patients that did not spontaneously urinate within 6-8 hours post operative will have an intervention. Potential interventions include : a) Prompted voiding and rescanning in 2 hours; b) Intermittent catheterization and patient prompting; c) Indwelling catheter inserted.

  Within 24 hours post operative

Study Arms (1)

Pre-operative Tamsulosin administration

EXPERIMENTAL

Subjects will be provided with a prescription for Tamsulosin (generic) to be taken 7 days prior to scheduled surgery for thoracic cancer. Tamsulosin dose is set at 0.4mg/day and should be taken daily for seven days prior to their planned surgery date. Study subjects will also be given a diary to record their daily usage. Study subjects should take Tamsulosin on the day of the surgery with a sip of water.

Drug: Tamsulosin

Interventions

Tamsulosin DRUG

Tamsulosin 0.4 mg one time daily after a meal for seven days prior to surgery. Post-surgery, an ultrasound of the bladder will be completed approximately six hours after surgery to assess the bladder. If the bladder ultrasound shows more than 400 cc of urine in the bladder, or if the study subject passes urine on his own and there is more than 100cc or less than 400 cc of urine left in the bladder, he will be encouraged to try to pass urine. Study subject will be monitored for two additional hours. If a study subject is unable to pass urine at this time or the bladder has 400 cc or more of urine left in it, he will have an intermittent catheter (in and out) to drain urine. If the bladder has greater than 500 cc (which is approximately 16 and two-thirds ounces) per catheterization for more than 24 hours, and the study subject cannot pass urine, an indwelling catheter may be considered.

Also known as: Flomax

Pre-operative Tamsulosin administration

Eligibility Criteria

• Age: 55 Years+
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Males
• ≥55 years old
• Planned thoracic oncological surgical procedure of a video assisted oncological surgical procedure for suspected or confirmed cancer.
• Surgery scheduled more than 7 days from the time of consent

You may not qualify if:

• Using Tamsulosin already
• Known allergy to Tamsulosin or sulfa drugs
• Current use of Boceprevir
• Resting systolic blood pressure \<100
• Orthostatic hypotension of \>20mm Hg systolic and/or 10mm Hg diastolic pressure from sitting to standing (after 2 minutes of standing) as measured at the time of consent
• Known history of hypotension
• Known diagnosis of congestive heart failure (CHF) and valvular heart disease
• History of prior prostate surgery (prostatectomy, trans-urethral resection)

Sponsors & Collaborators

• Hackensack Meridian Health: lead

Study Sites (4)

Ocean University Medical Center

Brick, New Jersey, 08724, United States

RECRUITING

South Ocean University Medical Center

Manahawkin, New Jersey, 08050, United States

RECRUITING

Jersey Shore University Medical Center

Neptune City, New Jersey, 07753, United States

RECRUITING

Riverview Medical Center

Red Bank, New Jersey, 07701, United States

RECRUITING

Related Publications (3)

• 1. Agrawal K, Majhi S, Garg R. Post-operative urinary retention: Review of literature. World J Anesthesiol 2019; 8(1): 1-12 [DOI: 10.5313/wja.v8.i1.1] 2. Akkoc A, Aydin C, Topaktas R, Kartalmis M, Altin S, Isen K, Metin A. Prophylactic effects of alpha-blockers, Tamsulosin and Alfuzosin, on postoperative urinary retention in male patients undergoing urologic surgery under spinal anaesthesia. Int Braz J Urol. 2016 May-Jun;42(3):578-84. doi: 10.1590/S1677-5538.IBJU.2015.0256. PMID: 27286124; PMCID: PMC4920578. 3. Baldani G, Bagry H, Aprikian A, et al. Post-Operative Urinary Retention. Anesthesiology 2009; 110 (5): 1139-1157. 4. Benjamin Wei, Ammar Asban, Rongbing Xie, Zachary Sollie, Luqin Deng, Thomas K. DeLay, William B. Swicord, Rajat Kumar, James K. Kirklin, James Donahue. A prediction model for postoperative urinary retention after thoracic surgery. JTCVS Open. Volume 7. 2021. Pages 359-366. ISSN 2666-2736. https://doi.org/10.1016/j.xjon.2021.05.006. 5. Fisher E, Subramonian K, Omar MI. The role of alpha blockers prior to removal of urethral catheter for acute urinary retention in men. Cochrane Database Syst Rev. 2014 Jun 10;(6):CD006744. doi: 10.1002/14651858.CD006744.pub3. PMID: 24913721.

  BACKGROUND

• 6. Hollingsworth JM, Rogers MA, Krein SL, et al. Determining the Noninfectious Complications of Indwelling Urethral Catheters. A Systemic Review and Meta-Analysis. Ann Intern Med 2013: 159; 401-410. 7. Jackson J, Davies P, Leggett N, Nugawela MD, Scott LJ, Leach V, Richards A, Blacker A, Abrams P, Sharma J, Donovan J, Whiting P. Systematic review of interventions for the prevention and treatment of postoperative urinary retention. BJS Open. 2018 Nov 19;3(1):11-23. doi: 10.1002/bjs5.50114. PMID: 30734011; PMCID: PMC6354194. 8. Kun Woo Kim, Jae-Ik Lee, Ji Sung Kim, Young-Jin Lee, Won-Jun Choi, Han Jung, Kook-Yang Park, Chul-Hyun Park, Kuk-Hui Son, Risk factors for urinary retention following minor thoracic surgery, Interactive CardioVascular and Thoracic Surgery, Volume 20, Issue 4, April 2015, Pages 486-492, https://doi.org/10.1093/icvts/ivu445 9. Lepor H, Tamsulosin Investigator Group. Phase III Multicenter Placebo-Controlled Study of Tamsulosin in Benign Prostatic Hyperplasia. Urology 1998: 51; 892-900. 10. Madani AH, Aval HB, Mokhtari G, et al. Effectiveness of Tamsulosin in Prevention of Post-Operative Urinary Retention: A Randomized Double-Blind Placebo-Controlled Trial. Braz J of Urol 2014; 40(1): 30-36.

  BACKGROUND

• 11. Patel JA, Kaufman AS, Howard RS, et al. Risk Factors for Urinary Retention after Laparoscopic Inguinal Hernia Repairs. Surg Endosc 2015: 29; 3140-3145. 12. R Core Team (2020). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/. 13. Simon R. (1989). Optimal Two-Stage Designs for Phase II Clinical Trials. Controlled Clinical Trials 10, 1-10. 14. Sivasankaran MV, Pham T, Divino CM. Incidence and Risk Factors for Urinary Retention Following Laparoscopic Inguinal Hernia Repair. Am J Surg 2014; 207: 288-292. 15. "Tamsulosin hydrochloride-Drug Summary." PDR Prescribers' Digital Reference (2021). Retrieved from https://www.pdr.net/drug-summary/Flomax-tamsulosin-hydrochloride-2893.5649 16. Venkatraman E. Seshan (2018). clinfun: Clinical Trial Design and Data Analysis Functions. R package version 1.0.15. Retrieved from https://CRAN.R-project.org/package=clinfun

  BACKGROUND

MeSH Terms

Conditions

Urinary Retention

Interventions

Tamsulosin

Condition Hierarchy (Ancestors)

Urination Disorders; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases

Intervention Hierarchy (Ancestors)

Benzenesulfonamides; Sulfonamides; Amides; Organic Chemicals; Benzene Derivatives; Hydrocarbons, Aromatic; Hydrocarbons, Cyclic; Hydrocarbons; Sulfones; Sulfur Compounds

Study Officials

• Thomas Bauer, MD

  Hackensack Meridian Health

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Denise Theiler, RN

CONTACT

7327763301; Denise.Theiler@hmhn.org

Study Design

• Study Type: interventional
• Phase: early phase 1
• Allocation: NA
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 12, 2022
• First Posted: December 20, 2022
• Study Start: April 3, 2023
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: February 10, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (4)