Summary. Catheterization remains the standard management of acute urinary retention (AUR), followed by a trial without catheter (TWOC) or prostatectomy in men who do not void spontaneously. If AUR is caused by increased sympathetic activity at the level of the prostatic smooth muscles, alpha-blockers (alpha-1 adrenoreceptor antagonists) should increase the likelihood of a successful trial without catheter (TWOC) following AUR. Alpha-blockers effectively reduce the symptoms associated with benign prostatic hyperplasia (BPH) and improve the urodynamic parameters of obstruction. They may diminish the incidence of AUR and the need for prostatectomy in symptomatic men. The adventage of tamsulosin and slow-release alfuzosin over doxazosin and terazosin in the management of AUR is that a therapeutic dose can be adminis- tered at the onset of AUR, thereby reducing the time for attempting catheter removal.