PURPOSE: We examine the complication and continence rates with early catheter removal (day 3 or 4) after radical retropubic prostatectomy. MATERIALS AND METHODS: A total of 365 patients with localized prostate cancer underwent radical retropubic prostatectomy at Indiana University Hospital with planned urethral catheter removal before discharge home. Low pressure cystograms were performed on postoperative day 3 or 4 to determine if catheter removal was possible. A subset of patients were analyzed using a validated prostate cancer specific questionnaire (University of California, Los Angeles Prostate Cancer Symptom Index) to determine quality of life outcomes. RESULTS: The catheter was removed on postoperative day 3 or 4 in 263 patients (72%). The reasons for leaving the catheter indwelling were significant leak on cystogram or excessive suprapubic drainage (21%), extensive bladder neck reconstruction (1%) and prolonged hospitalization because of an ileus or other complicating factor (6%). Thirteen patients (3.6%) were either unable to void after catheter removal or presented with retention (not associated with hematuria or clots) after hospital discharge, requiring reinsertion of the Foley catheter. A total of 41 patients (11%) had either an early or late complication (excluding incontinence). There were 3 complications (0.8%) that were considered major because they were potentially life threatening or required a return to the operating room. A pelvic abscess developed in 2 patients and a lymphocele in 1, which required percutaneous drainage. After at least 6 months (mean 20.9 months) 140 patients (89.2%) and 14 (8.9%) reported excellent and good continence, respectively. The patient questionnaire demonstrated bother scores to be minimal to no bother for 95% to 98% of patients at 6 and 12 months. CONCLUSIONS: This study confirms that it is safe to remove catheters in most patients 3 to 4 days after prostatectomy if a cystogram demonstrates no extravasation. Complication rates and continence rates with this approach compare favorably with series in which catheters are left indwelling for longer periods.
PURPOSE: We examine the complication and continence rates with early catheter removal (day 3 or 4) after radical retropubic prostatectomy. MATERIALS AND METHODS: A total of 365 patients with localized prostate cancer underwent radical retropubic prostatectomy at Indiana University Hospital with planned urethral catheter removal before discharge home. Low pressure cystograms were performed on postoperative day 3 or 4 to determine if catheter removal was possible. A subset of patients were analyzed using a validated prostate cancer specific questionnaire (University of California, Los Angeles Prostate Cancer Symptom Index) to determine quality of life outcomes. RESULTS: The catheter was removed on postoperative day 3 or 4 in 263 patients (72%). The reasons for leaving the catheter indwelling were significant leak on cystogram or excessive suprapubic drainage (21%), extensive bladder neck reconstruction (1%) and prolonged hospitalization because of an ileus or other complicating factor (6%). Thirteen patients (3.6%) were either unable to void after catheter removal or presented with retention (not associated with hematuria or clots) after hospital discharge, requiring reinsertion of the Foley catheter. A total of 41 patients (11%) had either an early or late complication (excluding incontinence). There were 3 complications (0.8%) that were considered major because they were potentially life threatening or required a return to the operating room. A pelvic abscess developed in 2 patients and a lymphocele in 1, which required percutaneous drainage. After at least 6 months (mean 20.9 months) 140 patients (89.2%) and 14 (8.9%) reported excellent and good continence, respectively. The patient questionnaire demonstrated bother scores to be minimal to no bother for 95% to 98% of patients at 6 and 12 months. CONCLUSIONS: This study confirms that it is safe to remove catheters in most patients 3 to 4 days after prostatectomy if a cystogram demonstrates no extravasation. Complication rates and continence rates with this approach compare favorably with series in which catheters are left indwelling for longer periods.
Authors: Serkan Altinova; Ege Can Serefoglu; Ahmet Tunc Ozdemir; Ali Fuat Atmaca; Ziya Akbulut; Mevlana Derya Balbay Journal: Int Urol Nephrol Date: 2009-01-23 Impact factor: 2.370
Authors: Aldo Brassetti; Flavia Proietti; Antonio Cardi; Antonio De Vico; Antonio Iannello; Alberto Pansadoro; Aldo Scapellato; Tommaso Riga; Paolo Emiliozzi; Gianluca D'Elia Journal: J Robot Surg Date: 2017-11-25
Authors: Nina Harke; Michael Godes; Jawid Habibzada; Katarina Urbanova; Christian Wagner; Henrik Zecha; Mustapha Addali; Jorn H Witt Journal: World J Urol Date: 2016-06-22 Impact factor: 4.226
Authors: Derya Tilki; Felix Preisser; Pierre Karakiewicz; Shahrokh F Shariat; Markus Graefen; Hartwig Huland; Felix K Chun; Raisa S Pompe Journal: World J Urol Date: 2018-03-26 Impact factor: 4.226
Authors: Karl Friedrich Kowalewski; Christian Tapking; Svetlana Hetjens; Felix Nickel; Philipp Mandel; Manuel Ritter; Maximilian Christian Kriegmair Journal: BMJ Open Date: 2017-11-25 Impact factor: 2.692