Post-operative Urinary Retention (POUR) Following Thoracic Surgery
Post-operative Urinary Retention (POUR) Following Thoracic Surgery
Inability to urinate a common complication that happens to many patients after a surgery,
 especially in men over 60 years of age who undergo surgery on their chest. Urinary retention
 is uncomfortable, increases anxiety, increases hospital length of stay, and leads to more
 procedures such as putting in a bladder catheter (Foley). This is uncomfortable, and can lead
 to bleeding, infection, damage to the urethra and/or bladder and bladder spasm. The goal of
 this study is to attempt to prevent inability to urinate by giving patients a medication
 called Flomax (Tamusolin) every day beginning a week before surgery. That medication relaxes
 the prostate. It's approved by the Food and Drug Administration (FDA) to improve urinary flow
 in those with enlarged prostates. It is also commonly used in patients with bladder problems
 due to inability to urinate who have required a Foley.
Post-operative urinary retention (POUR) in older men who undergo a thoracic surgical
 procedure occurs in a significant proportion of patients (25% at Hackensack University
 Medical Center in men >60) and is a significant management problem. Typically, this
 complication needs to be treated with placement of a bladder catheter (foley). In addition to
 the discomfort of placing a foley in an awake patient, these patients are at a significantly
 increased risk of a catheter associated urinary tract infection (CAUTI), potential
 genito-urinary injury during the placement, and bladder muscle damage due to distention.

 The goal of this study is to investigate whether the use of Tamusolin could lower the high
 incidence of POUR in older men undergoing a thoracic surgical procedure.

 The investigators hypothesize that pre-operative administration of Tamusolin (Flomax,
 0.4mg/day x 1 week), with ongoing use post-operatively until normal voiding resumes, will
 result in a significant decrease in the incidence of POUR after a thoracic surgical
 procedure.
Inclusion Criteria:

 -  Males

 -  ≥65 years old

 -  Planned surgical procedure of a video assisted thoracoscopic surgery (wedge resection,
 lobectomy, pleural biopsy, or pleurodesis)

 -  Surgery scheduled more than 7 days from the time of consent

 Exclusion Criteria:

 -  Using Flomax already

 -  Allergy to Flomax or sulfa drugs

 -  Current use of alpha blockers or alpha agonists

 -  Resting systolic blood pressure <100

 -  Orthostatic hypotension of >20mm Hg (millimeters of mercury) Systolic and/or 10mm Hg
 diastolic pressure from sitting to standing (after 2 minutes of standing) as measured
 at the time of consent

 -  Known diagnosis of congestive heart failure and valvular heart disease

 -  History of prostate surgery (prostatectomy, trans-urethral resection)