To the Editor.—Phenoxybenzamine hydrochloride is an extremely useful drug to facilitate the passage of urine in patients with bladder neck problems. Goldman et al1 demonstrated its usefulness in preventing urinary retention and also in treating urinary retention after surgery in patients who have difficulty.
I want to emphasize that phenoxybenzamine is an extremely potent and long-acting medication. The risk of orthostatic hypotension is considerable, and, in Goldman and colleagues' experience, four of 62 patients were excluded from the study group because of this complication. I have seen many patients with the side effect of orthostatic hypotension from this medication, and I think the use of this medication in elderly patients is risky at best. If elderly patients are hospitalized in a controlled situation and the nursing staff is aware of the possibility of orthostatic hypotension, use of the drug is less risky. Individuals with coronary artery disease and
CONFER DJ. Phenoxybenzamine and Urinary Retention. Arch Surg. 1988;123(10):1287-1288. doi:10.1001/archsurg.1988.01400340113025