Clinical Study Diethylstilbestrol 1 mg in the Treatment of Acute Urinary Retention due to Prostatic Obstruction in the Elderly: A Preliminary Study Leonardo Oliveira Reis, 1,2,3 Gustavo Borges De Mendonça, 2 Bruno D. Carneiro, 2 Edson Schneider, 2 Eduardo Varella Gewehr, 2 André Meirelles, 2 Fernandes Denardi, 3 and Antonio Gugliotta 1,3 1 Faculty of Medicine, Pontiical Catholic University of Campinas (PUC-Campinas), 13060-904 Campinas, SP, Brazil 2 Urology Division, Pontiical Catholic University of Campinas (PUC-Campinas), 13060-904 Campinas, SP, Brazil 3 Faculty of Medicine and Urology Division, University of Campinas (Unicamp), 13083-887 Campinas, SP, Brazil Correspondence should be addressed to Leonardo Oliveira Reis; reisleo@unicamp.br Received 31 July 2013; Revised 7 November 2013; Accepted 24 November 2013; Published 19 January 2014 Academic Editor: James A. Brown Copyright © 2014 Leonardo Oliveira Reis et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Patients who failed a catheter-free trial ater acute urinary retention and one week of full dose alpha-blocker and 5-alpha-reductase inhibitor were ofered Diethylstilbestrol 1 mg plus Aspirin 100 mg over 4 weeks. Prostate volume, age, serum creatinine, and initial retention drained urine volume were recorded. Ater excluding cardiovascular morbidity (=7), upper urinary tract dilation (=3), compromised renal function (=2), urinary tract infection (=2), neurological diagnosis (=2), or preferred immediate channel transurethral resection of prostate (=5), 48 of 69 consecutive patients ≥70 years were included. Mean age was 76.6 years (70–84), mean prostate volume 90 cm 3 (42–128), and mean follow-up 204 days; 58% (28/48) were passing urine and 42% (20/48) were catheter dependent ater 4 weeks Diethylstilbestrol trial. Mean age and drained urine volume of catheter dependent patients were 82.4 years and 850 mL compared with 74.6 years and 530 mL in catheter-free men, respectively. Age and drained urine volume were independent predictors of catheter-free trial (both  < 0.01). Seventy-ive percent (6/8) of patients 80 years and older were catheter dependent. Transient nipple/breast tenderness and gynecomastia were the only adverse efects reported by 21% (10/48) and 4% (2/48), respectively. No patient presented severe complications. 1. Introduction Acute urinary retention (AUR) is an important urological emergency in men [1–3]. It is characterized by a sudden and painful inability to pass urine voluntarily [1, 4]. Approxi- mately 10% of men aged 70 and a third of men aged 80 will have an AUR in the next 5 years [5]. Management of AUR consists of immediate bladder decompression by catheterization. he method and duration of catheterization as an initial treatment are primarily depen- dent within and among the countries, as is the decision to admit or send home ater catheterization [1, 6, 7]. Usually, standard management of nonhigh pressure acute retention is alpha-blocker for at least 48 hours followed by trial without catheter (TWOC) [6, 8, 9]. Subsequent handling is not well iled due to lack of guide- lines, mainly in those who fail TWOC [1]. his study aims to evaluate eicacy, safety, and adverse efects of DES 1 mg plus aspirin 100 mg over 4 weeks as a minimally invasive alterna- tive in an elderly population presenting with AUR secondary to prostatic obstruction who failed a catheter-free trial. 2. Methods Ater local ethics committee approval and patient consent, men over 70 years, age in an outpatient clinical setting presenting prostatic obstruction with AUR and who ater one week of full dose alpha-blocker and 5-alpha-reductase inhibitor have failed a catheter-free trial were invited to be Hindawi Publishing Corporation Advances in Urology Volume 2014, Article ID 984382, 4 pages http://dx.doi.org/10.1155/2014/984382