Effect of IV Dexamethasone on Post-op Urinary Retention After Spinal Anesthesia

NCT ID: NCT07077850

Last Updated: 2026-01-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

1084 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-08-20

Study Completion Date

2026-08-20

Brief Summary

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What is this study about? This study is testing whether a common medication called dexamethasone, given through a vein (IV) before surgery, can help prevent a problem called postoperative urinary retention (POUR). POUR means having trouble urinating after surgery, which can cause discomfort and sometimes requires using a catheter.

Who can join the study? The study includes adult People who are having surgery with spinal anesthesia at Al-Makassed Hospital. People who have certain medical conditions, use steroids regularly, or need a catheter during surgery cannot join.

What will happen in the study?

Participants will be randomly assigned to one of two groups:

* One group will get 8 mg of IV dexamethasone before surgery.
* The other group will get a saltwater (placebo) injection. Neither the participants nor the doctors will know which treatment they receive.

After surgery, the researchers will check how soon each participant can urinate and whether they need a catheter.

Why is this study important? POUR can slow recovery and cause complications. Dexamethasone is already used for other reasons like nausea and swelling. This study will help find out if it also lowers the risk of POUR in people getting spinal anesthesia.

Detailed Description

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Postoperative urinary retention (POUR) is a common complication following spinal anesthesia, affecting patient comfort, recovery, and sometimes requiring catheterization. While dexamethasone is routinely used to prevent nausea and inflammation in surgical patients, its potential role in preventing POUR has not been fully explored, especially in the context of spinal anesthesia.

This study is a prospective, randomized, double-blind, placebo-controlled clinical trial conducted at Al-Makassed Hospital. It aims to evaluate whether a single preoperative intravenous dose of 8 mg dexamethasone reduces the incidence of POUR in adult patients undergoing elective surgery under spinal anesthesia.

Eligible participants are randomized into two equal groups using block randomization. One group receives 8 mg of IV dexamethasone, and the other receives a placebo (0.9% saline). Both patients and assessors are blinded to group assignment. Data will be collected on age, BMI, comorbidities (including history of BPH or prior POUR), current anticholinergic drug use, anesthetic agent and dose, which level of spinal anesthesia (e.g. L3-L4), type of surgery, IV fluid volume, and duration of operation.

The primary outcome is the incidence of POUR, defined as failure to void within 6 hours after surgery and requiring catheterization. Secondary outcomes include time to first void and the overall need for urinary catheterization. Safety data will also be recorded, and any adverse events related to dexamethasone will be reported.

The study has been approved by the Al-Quds University Research Ethics Committee. All participants will provide informed consent prior to enrollment.

Conditions

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Post Operative Urinary Retention Spinal Aneshtesia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants are randomly assigned in a 1:1 ratio to receive either a single 8 mg dose of intravenous dexamethasone or a placebo (0.9% normal saline) prior to surgery under spinal anesthesia. Each participant remains in their assigned group throughout the study.
Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
This is a double-blinded study. Both participants and outcome assessors are unaware of the group assignments. A non-participating physician performed the randomization using a computer-generated block randomization list. Study drugs (dexamethasone or placebo) are prepared in identical syringes labeled with participant codes only, ensuring that care providers and investigators remain blinded during the intervention and follow-up period.

Study Groups

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Arm 2: Placebo Group (Participants receiving intravenous 0.9% saline as placebo)

Participants in this arm will receive an intravenous injection of 0.9% normal saline (placebo) before undergoing surgery under spinal anesthesia. This group is used to compare the effect of dexamethasone on the incidence of postoperative urinary retention (POUR).

Group Type PLACEBO_COMPARATOR

Normal Saline (0.9% NaCl)

Intervention Type DRUG

Intravenous administration of 0.9% normal saline (placebo) given as a single dose before surgery under spinal anesthesia. This inert solution is used to compare against the active drug dexamethasone to determine its effect on postoperative urinary retention (POUR).

Arm 1: Dexamethasone group

Participants in this arm will receive a single 8 mg dose of intravenous dexamethasone before undergoing surgery under spinal anesthesia. The intervention is administered preoperatively to evaluate its effectiveness in reducing the risk of postoperative urinary retention (POUR).

Group Type EXPERIMENTAL

Dexamethasone (IV)

Intervention Type DRUG

Intravenous administration of 8 mg dexamethasone sodium phosphate given as a single dose before surgery under spinal anesthesia. This corticosteroid is being evaluated for its potential to prevent postoperative urinary retention (POUR) by reducing inflammation and other perioperative effects.

Interventions

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Dexamethasone (IV)

Intravenous administration of 8 mg dexamethasone sodium phosphate given as a single dose before surgery under spinal anesthesia. This corticosteroid is being evaluated for its potential to prevent postoperative urinary retention (POUR) by reducing inflammation and other perioperative effects.

Intervention Type DRUG

Normal Saline (0.9% NaCl)

Intravenous administration of 0.9% normal saline (placebo) given as a single dose before surgery under spinal anesthesia. This inert solution is used to compare against the active drug dexamethasone to determine its effect on postoperative urinary retention (POUR).

Intervention Type DRUG

Other Intervention Names

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Dexamethasone Sodium Phosphate Isotonic Saline

Eligibility Criteria

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Inclusion Criteria

* Adult patients at Al-Makassed Hospital undergoing spinal anesthesia for surgery

Exclusion Criteria

* Chronic steroid use
* Individuals who should not be administered dexamethasone
* Have a history of urological issues or procedures
* Have neurological disorders
* Using an intraoperative Foley's catheter
* Operations for possible nerve damage
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Al-Quds University

OTHER

Sponsor Role lead

Responsible Party

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Abeer Hasan

Abeer Jafar Dar Hasan , General Surgery Senior Resident, MBBS

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Abeer J Dar Hasan, MD

Role: PRINCIPAL_INVESTIGATOR

Al-Makassed Islamic Charitable Society Hospital and Al-Quds University

Mohammed M Maree, MD

Role: STUDY_DIRECTOR

Al-Makassed Islamic Charitable Society Hospital and Al-Quds University

Locations

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Al-Makassed Islamic Charitable Society Hospital

East Jerusalem, Al-Makassed Islamic Charitable Society Hospital, Palestinian Territories

Site Status

Countries

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Palestinian Territories

References

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Neff SP, Stapelberg F, Warmington A. Excruciating perineal pain after intravenous dexamethasone. Anaesth Intensive Care. 2002 Jun;30(3):370-1. doi: 10.1177/0310057X0203000319.

Reference Type BACKGROUND
PMID: 12075649 (View on PubMed)

Toftegaard M, Knudsen F. Massive vasopressin-resistant polyuria induced by dexamethasone. Intensive Care Med. 1995 Mar;21(3):238-40. doi: 10.1007/BF01701480.

Reference Type BACKGROUND
PMID: 7790612 (View on PubMed)

Primack A, Kajubi S. Insulin and growth hormone response to an oral glucose load in Ugandan hepatocellular carcinoma patients. East Afr Med J. 1974 Aug;51(8):574-8. No abstract available.

Reference Type BACKGROUND
PMID: 4371198 (View on PubMed)

Denham M, Donovan K, Wetoska N, Kuchta K, Carbray J, Linn JG, Denham W, Haggerty SP, Joehl R, Ujiki M. Effects of dexamethasone on postoperative urinary retention after laparoscopic inguinal hernia repair. Surg Endosc. 2019 Sep;33(9):3008-3013. doi: 10.1007/s00464-018-6572-7. Epub 2018 Nov 7.

Reference Type BACKGROUND
PMID: 30406386 (View on PubMed)

Splinter WM, Roberts DJ. Dexamethasone decreases vomiting by children after tonsillectomy. Anesth Analg. 1996 Nov;83(5):913-6. doi: 10.1097/00000539-199611000-00004.

Reference Type BACKGROUND
PMID: 8895262 (View on PubMed)

Levin RM, Longhurst PA, Monson FC, Kato K, Wein AJ. Effect of bladder outlet obstruction on the morphology, physiology, and pharmacology of the bladder. Prostate Suppl. 1990;3:9-26. doi: 10.1002/pros.2990170503.

Reference Type BACKGROUND
PMID: 1689174 (View on PubMed)

Kamphuis ET, Ionescu TI, Kuipers PW, de Gier J, van Venrooij GE, Boon TA. Recovery of storage and emptying functions of the urinary bladder after spinal anesthesia with lidocaine and with bupivacaine in men. Anesthesiology. 1998 Feb;88(2):310-6. doi: 10.1097/00000542-199802000-00007.

Reference Type BACKGROUND
PMID: 9477049 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan: Proposal

View Document

Document Type: Study Protocol and Statistical Analysis Plan: application form

View Document

Document Type: Study Protocol and Statistical Analysis Plan: check list

View Document

Document Type: Study Protocol and Statistical Analysis Plan: REC approval

View Document

Other Identifiers

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DEX-PUR Trial

Identifier Type: -

Identifier Source: org_study_id

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