The acute urinary retention and response to the medical or surgical therapy is dependent on the many factors as the following;
1) Size of the prostate and particular lobe pressure on the neck of the bladder.
2) Contractility of the bladder muscle.
3) Pelvic floor dysfunctions.
All of these are assessed by investigations like PSA, uroflowmetry, CT scan/ultrasound, and video urodynamics.
These would also guide whether only surgery would be effective.
Majority of the patients do respond to Tamsulosin and failure of it is again an indication of the surgerical treatment.
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