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NCT Number: NCT07654413

Tamsulosin With or Without Tadalafil for Trial Without Catheter After Acute Urinary Retention Due to Benign Prostatic Hyperplasia

Acute urinary retention is a common emergency in men with benign prostatic hyperplasia. After bladder drainage with a urethral catheter, patients usually undergo a trial without catheter to determine whether they can pass urine again without recatheterization.

This study will evaluate whether adding tadalafil 5 mg once daily to tamsulosin 0.4 mg once daily improves the chance of successful trial without catheter in men with first-episode acute urinary retention due to presumed benign prostatic hyperplasia.

Participants will be randomly assigned to receive either tamsulosin plus tadalafil or tamsulosin plus a matching placebo. Study medication will start within 24 hours after catheterization. The catheter will be removed on Day 7. If the first trial without catheter fails, the catheter will be reinserted and a second rescue trial without catheter will be performed on Day 14.

The main outcome is overall catheter-free success by Day 14. Participants will also be followed for recurrent urinary retention, post-void residual urine, urinary flow, catheter-related complications, drug-related adverse events, and the need for benign prostatic hyperplasia-related surgery within 3 months.

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Key information

Conditions

Acute Urinary Retention Benign Prostatic Hyperplasia Benign Prostatic Obstruction Genital Diseases Genital Diseases, Male Male Urogenital Diseases Prostatic Diseases Prostatic Hyperplasia Urogenital Diseases

Age range

50 year and older

Sex eligibility

Male

Study type

Interventional

Phase

Phase 4

Primary location

Department of Urology- Beni-Suef University Hospitals

Banī Suwayf, Beni Suweif Governorate, 02456, Egypt

Location status: Recruiting

Location contact

Hany F Badawy, MD

CONTACT

[email protected]

+201149525028

Hany F Badawy, MD

PRINCIPAL_INVESTIGATOR

CONTACT

[email protected]

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male patient aged 50 years or older.
  • First episode of spontaneous painful acute urinary retention.
  • Successful urethral catheterization at presentation.
  • Drained urine volume at presentation of at least 300 mL.
  • Clinical impression of benign prostatic obstruction or benign prostatic hyperplasia based on history, digital rectal examination, and/or ultrasound evidence of enlarged prostate.
  • Ability to provide written informed consent.

Exclusion criteria

  • Previous episode of acute urinary retention.
  • Chronic painless urinary retention phenotype.
  • Active urinary tract infection or sepsis.
  • Gross hematuria with clot retention.
  • Suspected or known urethral stricture.
  • Neurogenic bladder or major neurologic disease affecting voiding.
  • History of prostate cancer or bladder cancer.
  • Previous prostate surgery.
  • Current use of nitrates or guanylate cyclase stimulators.
  • Contraindication to tadalafil or tamsulosin.
  • Severe hypotension or unstable cardiovascular disease.
  • Severe renal impairment.
  • Severe hepatic impairment.
  • Current or recent use of phosphodiesterase type 5 inhibitors before enrollment.

Treatment and study plan

Tamsulosin

Drug

Tamsulosin 0.4 mg will be administered orally once daily as open-label background therapy in both study arms. Treatment will start within 24 hours after urethral catheterization and continue until the scheduled Day-7 trial without catheter. Participants who fail the Day-7 trial without catheter will continue treatment until the rescue trial without catheter on Day 14.

Tadalafil

Drug

Tadalafil 5 mg will be administered orally once daily in the experimental arm in addition to open-label tamsulosin 0.4 mg once daily. Treatment will start within 24 hours after urethral catheterization and continue until the scheduled Day-7 trial without catheter. Participants who fail the Day-7 trial without catheter will continue treatment until the rescue trial without catheter on Day 14.

Tadalafil Placebo

Drug

A matching placebo tablet will be administered orally once daily in the placebo comparator arm in addition to open-label tamsulosin 0.4 mg once daily. The placebo will be identical to tadalafil in appearance, packaging, and labeling to maintain blinding.

Primary outcomes

  1. Overall Catheter-Free Success by Day 14

    Time frame: Day 14

    Proportion of participants who achieve successful spontaneous voiding after either the scheduled Day-7 trial without catheter or the rescue Day-14 trial without catheter. Success is defined as spontaneous voiding after catheter removal, voided volume of at least 100 mL, post-void residual urine less than 150 mL measured within 10-15 minutes after voiding, no recatheterization within 24 hours after the relevant trial without catheter attempt, and remaining catheter-free until Day 14 for participants who initially pass the Day-7 trial without catheter.

Secondary outcomes

  1. Successful Day-7 Trial Without Catheter

    Time frame: Day 7

    Proportion of participants who achieve successful spontaneous voiding after catheter removal on Day 7. Success is defined as spontaneous voiding, voided volume of at least 100 mL, post-void residual urine less than 150 mL measured within 10-15 minutes after voiding, and no recatheterization within 24 hours.

  2. Successful Rescue Day-14 Trial Without Catheter Among Day-7 Failures

    Time frame: Day 14

    Proportion of participants who fail the Day-7 trial without catheter and subsequently achieve successful rescue trial without catheter on Day 14 using the same predefined success criteria: spontaneous voiding, voided volume of at least 100 mL, post-void residual urine less than 150 mL measured within 10-15 minutes after voiding, and no recatheterization within 24 hours.

  3. Recurrent Acute Urinary Retention Within 30 Days

    Time frame: 30 days

    Proportion of participants who develop recurrent painful acute urinary retention requiring recatheterization within 30 days after randomization.

  4. Need for Benign Prostatic Hyperplasia-Related Surgery Within 3 Months

    Time frame: 3 months

    Proportion of participants who require surgical intervention for benign prostatic hyperplasia or benign prostatic obstruction within 3 months after randomization.

Study contacts

Contact information is provided by the study sponsor or research team.

Hany F Badawy, MD

CONTACT

[email protected]

+201149525028

Sponsors and collaborators

Lead sponsor

Beni-Suef University

Other

Registry information

Official study title

Tamsulosin With Versus Without Tadalafil for Trial Without Catheter After Acute Urinary Retention Due to Benign Prostatic Hyperplasia: A Prospective Double-Blind Randomized Trial

Acronym: TAMS-TAD-TWOC

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Jun 17, 2026
Registry last updated
Jun 17, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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