Letters

Acute urinary retention in men

BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7215.1004a (Published 09 October 1999) Cite this as: BMJ 1999;319:1004

Management is more complex issue than was described

  1. Jeremy J Elkabir, higher surgical trainee in urology (the.elk@virgin.net),
  2. Anup Patel, consultant urologist,
  3. Justin A Vale, consultant urologist,
  4. Ross O'N Witherow, consultant urologist
  1. St Mary's Hospital, Imperial College of Science Technology and Medicine, London W2 1NY
  2. Institute of Urology and Nephrology, University College Hospital, London W1P 7PN
  3. St George's Hospital, London SW17 0QT

    EDITOR—Emberton and Anson's review of acute urinary retention was timely and informative.1 In part of it they focused on the use of finasteride to reduce the risk of the disease.2 We disagree with them that the continuous administration of finasteride for four years is probably warranted in men with large prostates, moderate to severe symptoms, and poor urinary flow rates.

    Firstly, the cost implications are enormous. To prevent one event (acute urinary retention or prostatectomy) 15 patients would have to be treated for four years at a cost of £19 475.3 Secondly, the reduction in mean symptom scores with long term finasteride treatment is small (mean reduction 3.3 points) and not comparable with …

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